Chariot Learning Student Information Form
Please complete this form to begin the process of enrolling in a Chariot Learning practice test, class, seminar, or tutoring program. We look forward to working with you and your family!
* Required
Student Name
*
Your answer
School
*
Your answer
H.S. Graduation Year
*
Your answer
Which of our programs are you interested in? Please be as specific about PROGRAM and DATE as possible.
*
Your answer
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?
*
Yes
No
Honors, AP, or IB History?
*
Yes
No
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
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
Are you working with any other professionals regarding college admissions or finance? If so, who?
*
Your answer
Do you have a particular class, program, or teacher in mind? Is there anything else we should know?
*
Your answer
Next
Page 1 of 2
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
