Information Request Form
Email *
Parent Contact Information
Name: *
 Email Address *
Home Phone
Cell/Work Phone
Address
Zip Code *
Are you a returning client?
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Child Information
Birthdate allows Bright Kids to pinpoint your child's testing needs.
Child Name
Birth Date *
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DD
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YYYY
Child(ren) applying for: *
Required
Current Grade *
Preferred Location
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I am interested in the following tests/subjects: (Check all that apply)
Message (Please elaborate on your inquiry)
How did you hear about Bright Kids? *
Required
Send me newsletters and special promotions
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We offer a 15 minute Free consultation with our CEO and Founder Bige Doruk.  Here is the link to the consultation schedule.  https://go.oncehub.com/BrightKids?bt=1. Please provide any specific questions you would like to discuss, if you want to have the consultation.
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