To register, please fill out this form completely and press submit. One of our staff will contact you as soon as possible to discuss getting started.  Please be aware that individual slots fill up fast, especially those with Dr. Michael K. Smith.  If your first choice instructor is not available, we'll help you select an available alternate.
 FIRST AND LAST NAME OF STUDENT:
 
 FIRST AND LAST NAME OF PARENT:
 

 MAILING ADDRESS:
 

  E-MAIL ADDRESS:
 
 PHONE NUMBER:
 

 NAME OF HIGH SCHOOL:
 

  I WOULD LIKE TO REGISTER FOR...
 ANTICIPATED TEST DATE:
 

 CURRENT GRADE IN SCHOOL:
 

COMMENTS:

PLEASE BE AS SPECIFIC AS POSSIBLE.

IF REGISTERING FOR A SMALL GROUP CLASS, PLEASE INDICATE PREFERRED CLASS TIME.


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