Launchpad Registration Fall 2022- Spring 2023

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Thank you for your interest in Launchpad! Please submit this form as soon as possible, as space is limited. Payment is due at the time of registration. Cost is $275 per person. This covers all 8 sessions plus snacks. If you would like to inquire about scholarships, please email kimeryL@gmail.com. You will receive a confirmation email of registration in the upcoming weeks. Registration is guaranteed for the first 25 students who sign up and pay in each group; a waitlist will be offered after that time. Those who are waitlisted and not enrolled by the beginning of the program will be refunded. No other refunds will be given.

Your first and last name *

Your email address *

Your phone number *

Student's first and last name *

Student's email address *

Student's phone number *

Student's preferred group *

Female-identifying

Male-identifying

Payment info *

Venmo @Kimery (Please note it's for "Launchpad" and your student's name)

PayPal kimarj@gmail.com (Please note it's for "Launchpad" and your student's name)

Mail check to Launchpad, c/o Kimery Leong, 121 Arbor Dr, Piedmont, CA 94610

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