Chariot Learning Student Information Form
Please complete this form to begin the process of enrolling in a Chariot Learning practice test, class, workshop, or tutoring program. We look forward to working with you and your family!
Student Name *
Your answer
School *
Your answer
H.S. Graduation Year *
Your answer
Which of the following programs are you interested in? (Select as many as you want.) *
Required
Parent Name *
Your answer
Parent Email *
Your answer
Parent Phone *
Your answer
How did you hear about us? (Be as specific as possible.) *
Your answer
Student GPA *
Your answer
Current (or just completed) Math Course *
Your answer
Current (or just completed) Science Course *
Your answer
Honors, AP, or IB English? *
Honors, AP, or IB History? *
Previous ACT Scores (if any) *
Your answer
Previous SAT Scores (if any) *
Your answer
Previous PSAT Scores (if any) *
Your answer
Student Extracurricular Activities *
Your answer
Learning Disabilities or Testing Accommodations
Your answer
Weekday/Weekend Availability
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
8:00am-3:00pm (During a free period at school
3:00pm-6:00pm
6:00pm-9:00pm
Unavailable this day
Target Test Date
Your answer
Did you have a particular class, program, or teacher in mind? Is there anything else we should know? *
Your answer
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