Windward Science and Robotics

Student Information:
Name: ________________________
Grade: ______  Teacher:___________

Child in A+? ____________

Parent(s) Information:
Name(s): _________________________________
Address: _________________________________________

_________________________________________

Phone Number(s):
Home: ________________________
Cell:    ________________________

Email: ____________________________________

Registering For:

    ___Fun Season Robotics ($150.00)
    ___Junior Mathletes ($150.00)
    ___Junior Science Club ($150.00)
    ___Senior Mathletes ($150.00)
    ___Senior Science Club ($150.00)

Payment Options:
    ___Full payment (due with Registration)

    ___3 Installments

            ($50.00/class due with Registration,                         $50.00/class due 1 Mar,                                            $50.00/class due 1 May.)
    
    ___Applying for PTSA Scholarship.

Each program will run 14 + weeks.  Registration will begins 13 January 2008.

To register your child, print this page and fill out all the requested information.

Registration forms (with payment) can be returned to the PCNC Room or mailed to:

Aikahi Elementary
ATTN: Dave Eachus
281 Ilihau Street
Kailua, HI  96734

Payment must accompany registration form. 

If paying by installment, 1st installment must accompany registration form. 

If applying for PTSA Scholarship Funding, scholarship application must accompany registration form.