Two Teachers Tutoring ACT Boot Camp Registration
This form is to register for our ACT Boot Camp at COOSA PINES FEDERAL CREDIT UNION Childersburg branch. The session will be held on Saturday, October 16 from 9:00AM to 12:30PM CST.

Your $130 payment is due at check in. Please arrive 15 minutes early to sign in and make your payment. You may also pre-pay with Venmo @Chamiller.

Thank you for registering and we look forward to working with you!
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Email *
Student Last Name *
Student Preferred First Name *
Grade Level *
What school do you attend? *
When are you taking the ACT? *
Have you taken the ACT previously? *
List your most recent ACT English score: *
List your most recent ACT math score: *
List your most recent ACT reading score: *
List your most recent ACT science score: *
List your most recent ACT composite score: *
List any health conditions that we need to know about. *
Please provide emergency contact and phone number. *
How did you hear about us? If someone referred you, please list his or her name. *
You will receive an email confirming your registration immediately. We will send a reminder email with additional details a few days before the event.
A copy of your responses will be emailed to the address you provided.
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