Name & Last Name of Student
Phone
Cell Phone
Email
Language of Interest
Available Date for Evaluation:
Time Available for Evaluation:
Location:	San Patricio Caguas
If you answer YES, please fill the next field.
Fecha de Ultimo Curso :
Do you have been evaluated within the last year with PALI? Yes No
Do you belong to PALI KIDS (Age 6-17)? Yes No
If you answer YES, please fill the next fields
Name of Parent:
Age of Student:
¿Who is Responsable for the Payment ?
Company Yourself Parent or Legal Guardian Others
The placing evaluation has a $25 fee that will be reimbursed at registry if the student enrolls. Please wait and official confirmation with the exact date and time of your appointment for the placing evaluation. The evaluation lasts approximately and hour. The results will only be valid for a year after the date of the evaluation.