Willie Ross School for the Deaf
Sign Language Class Registration Form
(please print and mail with check  to Willie Ross School for the Deaf)
or fax to (413) 567-8808 (check should be mailed)
Name: _____________________________________
Address:
_____________________________________
Street
_____________________________________
City/Town
_____________________________________
State             Zip
Telephone:
_____________________________________
Home
_____________________________________
Work
*

Are you a family member of a Willie Ross Student?  Yes____ No____ (please check one)
*

If yes, please indicate the student's last name:________________________________
Please check
your class
selection
*

Beginner ______               Advanced Beginner ________

Intermediate _______        Advanced Conversation ________

*Final determination of placement will be made by the school.  In case of class changes, please see the Head Teacher or Coordinator to request assistance.

______FOR OFFICE USE ONLY  _______

Fee _______   Paid by Check________ Cash_______
 
Text ___________Paid by Check_______Cash______
 
The Willie Ross School for the Deaf, founded in 1967, is a private, non-profit, Chapter 766 approved school for deaf and hard-of-hearing students.  Programs range from early childhood through high school for students ages 3 to 22.  The Outreach Department also offers Early Intervention services for deaf and hard-of-hearing children 0 - 3 years. The school offers total communication classes as part of its Outreach services. The goal of the program is to facilitate communication among hearing, hard-of-hearing, and deaf individuals.

Willie Ross School for the Deaf
Outreach Department
Center for Total Communication

32 Norway Street, Longmeadow, MA 01106-3198