Registration - CCAC Tutoring Program — Cameroonian Canadian Association of Calgary

It is subject to annual fees payable through Interac Email Money Transfer (EMT) to: info@ccac-accc.org

Student Name

First Name

Last Name

Gender

Date of Birth

MM

DD

YYYY

Phone

(###)

###

####

Email

Postal Address

Current School / Academic level

Spoken and Written Languages

Preferred Course(s)

Mathematics

Sciences

French

English

Parent(s) Contact(s)

Name(s)/ Telephone(s)/ Email(s)

Parent(s) CCAC Member(s)

Emergency Contacts

Name(s)/ Telephone(s)/ Email(s)

Name of the Family

Tutoring Fees Type