American Heritage Education Inquiry Form Plantation Campus
Please provide information about the parent/guardian. Please provide either email or phone number for us to contact you.
Parent First Name*
Parent Last Name*
Parent Email*
Contact Phone Number*
Address
City
State
Zip
Information about course options
Specific Courses/Classes
Session Dates (You can chose more than one)
Session 1 : June 10 - June 28
Session 2: July 1- July 19(closed July 4)
Session 3: July 22 - August 9
PSAT/SAT test prep
Yes
No
Grade Forgiveness (Fill in Course/Class)
Please provide information about your child(ren).
Child First Name
Child Last Name
Age
Current Grade
PK3
PK4
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Current School
Do you want to enter another child's information
Yes
No
Child First Name
Child Last Name
Age
Current Grade
PK3
PK4
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Current School
Do you want to enter another child's information
Yes
No
Child First Name
Child Last Name
Age
Current Grade
PK3
PK4
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Current School
Please select all the education programs you wish to receive information.
Summer Education
Summer Institute for Advancement/Enrichment
Summer School (Grade forgiveness/improvement/remedial)
American Heritage Planation Campus
12200 West Broward Blvd
Plantation , FL 33325
(954) 472 -0022