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Summer Science Registration and ACT Prep Class Registration
Please complete the following form to register for a Summer Science class or for the ACT Prep Class. You will receive a confirmation e-mail from me once I receive the form. I will give instructions for fee payment in the e-mail. Thanks!!
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Student Name
*
(first and last)
Your answer
Student Grade Level for 2013-2014 school year
*
Check the one that applies.
9
10
11
12
Required
Parent Name
*
(first and last)
Your answer
Mailing Address
*
Your answer
Parent e-mail address
*
Your answer
Student e-mail address
*
Your answer
Select class you are registering for:
*
Biology 1
Chemistry 1
Chemistry 2
ACT Prep
Contact phone number
*
Please list the best contact phone number to use in case of emergency.
Your answer
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