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!
Student Name *
School *
H.S. Graduation Year *
Which of our programs are you interested in? Please be as specific about PROGRAM and DATE as possible. *
Parent Name *
Parent Email *
Parent Phone *
How did you hear about us? (Be as specific as possible.) *
Student GPA *
Current (or just completed) Math Course *
Current (or just completed) Science Course *
Honors, AP, or IB English? *
Honors, AP, or IB History? *
Previous ACT Scores (if any) *
Previous SAT Scores (if any) *
Previous PSAT Scores (if any) *
Student Extracurricular Activities *
Learning Disabilities or Testing Accommodations
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
Are you working with any other professionals regarding college admissions or finance? If so, who? *
Do you have a particular class, program, or teacher in mind? Is there anything else we should know? *
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