Enrollment Form

Date

MonthDayYear
Date
LanguageBird Enrollment Form

Smart bird! We can't wait to have you learn with us! Please note it may take 5-7 school days to get matched with an instructor.
Student Information
Student Full Name*

First NameLast Name
Student is a*

new studentreturning student (re-enrolling)
Home Phone Number*
Cell Phone Number*
Student Email*

Confirmation Email
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth*

MonthDayYear
Sex*

MaleFemaleOther
Pronouns
Current School*
If not attending a school, please write "n/a"
High School Graduation Year
Required if student is in High School

Parent Information

*Required if student is under the age of 18.
Parent Full Name

First NameLast Name
Parent Email
Home Phone Number
Cell Phone Number

Course Enrollment Information
Language:*
Choose Language
Course Level:*
Give us your best guess! Course Level (1-6)
Have you taken any courses or have prior experience with the language? Do you have any specific goals for learning the language?
None is needed. We'd just like to know what you've done!
Do you have an IEP, 504 plan or need to request any learning accommodations?
High School Students: If we know, we can determine how we can help.
Setting Your Schedule
We use the scheduling information you provide below to match you with your instructor. If availability is unclear, this will delay the matching process.
- Please include specific times, including time zone, and days that your student can meet with their instructor.
- Unfortunately, we cannot accommodate rotating or block school scheduless
- We ask that you pick days of the week and times that work for you weekly.
- If you cannot provide specific availability, we will not be able to match you until you provide it.
- If you change your availbility right after you enroll, it will cause a delay in the matching process.
It typically takes us 5 to 7 school days to match your availability with our instructors'.
How many times a week would you like to meet with your instructor for a lesson?*
Most students take lessons 2 to 3 times a week
How many times a week would you like to meet with your instructor for a lesson?
Most students take lessons 2 to 3 times a week.
What is your first choice for day(s) of the week and time(s) you would like to take your lessons? Please include your time zone.*
*This will help us match you with an instructor. Please put your time zone and am/pm.
What is a second option for day(s) of the week and time(s) you would like to take your lessons? Please include your time zone. *
*This will help us match you with an instructor. Please put your time zone and am/pm.
Do you wish to continue with the same instructor? If you have not confirmed your times already with an instructor, please include your scheduling needs below. Please include days, times and time zone. If you have confirmed with your instructor, please provide your planned schedule. *
Please include your time zone
When would you like to start your lessons? (Note: 5-7 school days required from enrollment to start date.)*

MonthDayYear
When would you like to start?*

Payment and Terms

Program Type:*

Full Year Course for Credit - Tuition:$2,275.00

Single Semester Course for Credit - Tuition:$1,250.00

Semester Options

Tutoring or Test Prep Lessons$510.00

Tutoring/Test Prep Lessons

Conversational Lessons$445.00

Conversation Lessons

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Confirmation*
Parent Signature*

Clear
Required if student is under 18 years of age.
How did you originally hear about LanguageBird?*
JotForm Lead Source
Lifecycle Stage
If you are having trouble submitting this form, please call an admissions advisor for support at 844-689-5810.

We are happy to help complete your enrollment over the phone.
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LanguageBird Enrollment Form

Student Information

Parent Information

Course Enrollment Information

Setting Your Schedule

Payment and Terms