SuprAcademy Pre-Registration Form
Please note that this is only the first step towards enrollment. Student will only be considered enrolled in our program after we contact the parent/guardian and follow up with the next steps.
Student
First Name *
Your answer
Last Name *
Your answer
Current School Name
Your answer
Grade *
Your answer
What subject is student looking to work with us?
Parent/ Guardian
First Name *
Your answer
Last Name *
Your answer
Email Address
Your answer
Would you like your email to be added to our mailing list for future opportunities and updates from SuprAcademy? *
Address
Street Address
Your answer
City *
Your answer
Province *
Your answer
Postal Code
Your answer
Country *
Your answer
Primary Phone Number *
Your answer
Emergency Contact
Name
Your answer
Relationship to Student
Your answer
Contact Number
Your answer
Submit
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