SAT Course Registration

This registration is for the new SAT Prep course at Santa Cruz Learning Center


Course Tuition: $400 (Free repeat. This course may be repeated as many times as you would like before graduation!)

Students Name
Your answer
Student's Phone(s) (home and Cell)
Your answer
Student's School
Your answer
Student's Grade Level as of Fall 2017
Your answer
Parent or Guardian 1 Name and Relationship to Student
Your answer
Parent or Guardian 1 Phone Numbers (Home, work and cell)
Your answer
Mailing Address Parent 1:
Address, City and Zip
Your answer
Parent or Guardian 1 Email Address
Your answer
Best way to reach Parent or Guardian 1?
Your answer
Parent or Guardian 2 Name and Relationship to Student
Your answer
Phone numbers of Parent or Guardian 2 (home, cell, work)
Your answer
Mailing Address Parent 2:
Address, City and Zip
Your answer
Email Address of Parent or Guardian 2
Your answer
Best way to reach Parent or Guardian 2
Your answer
High School Name
Your answer
How did you learn about our SAT prep course?
Your answer
Does the student have any learning differences? If so, please describe
Your answer
Is there anything else that you would like to add?
Your answer
How would you like to pay for the course?
Waiver portion: By entering my name in the box below, I agree not to hold Santa Cruz Learning Center, or the owners, Malika and Nathaniel Bell, or any tutors or independent contractors at the Santa Cruz Learning Center liable for any physical or psychological injuries to me or my child, which could possibly occur at the Santa Cruz Learning Center.
Enter your full name name here
Your answer
Date
enter the date here
Your answer
Submit
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