Info Request Form
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? *
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