SAT Course Registration

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


Course Tuition: $500 (Free repeat. This course may be repeated as many times as you would like before graduation!)
Students Name *
Student's Phone(s) (home and Cell)
Student's School
Student's Grade Level as of Fall 2019
Which Class would you like to sign up for? *
Parent or Guardian 1 Name and Relationship to Student
Parent or Guardian 1 Phone Numbers (Home, work and cell)
Mailing Address Parent 1:
Address, City and Zip
Parent or Guardian 1 Email Address
Best way to reach Parent or Guardian 1?
Parent or Guardian 2 Name and Relationship to Student
Phone numbers of Parent or Guardian 2 (home, cell, work)
Mailing Address Parent 2:
Address, City and Zip
Email Address of Parent or Guardian 2
Best way to reach Parent or Guardian 2
How did you learn about our SAT prep course?
Does the student have any learning differences? If so, please describe
Is there anything else that you would like to add?
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
Date *
enter the date here
Submit
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