Two Teachers Tutoring ACT Boot Camp Registration
This form is to register for our December 2022 ACT Boot Camp. The session will be held on Thursday, December 8 from 6:00 to 9:30 p.m. at Allegiance Staffing in LaGrange, GA. Please arrive 15 minutes early to sign in.

Your $150 payment can be made prior to the event via Venmo or you may pay in cash at check-in. If you use Venmo to pre-pay, please send the payment to @Chamiller and be sure to write the participant's name in the comment section.

You will receive an email prior to the session with important details regarding the event. Thank you for allowing us to work with you!  
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Email *
Student Last Name *
Student First Name *
Grade Level *
When are you taking the ACT? *
What school do you attend? *
Have you taken the ACT before? *
List your most recent ACT English score: *
List your most recent ACT math score: *
List your most recent ACT reading score: *
List your most recent ACT science score: *
List your most recent ACT composite score: *
Do you have any medical issues that we need to be aware of (allergies, seizures, etc.)? If so, please describe in detail any information that we need to know. *
Student Email *
Student Phone Number *
Parent Email *
Parent Phone Number *
How did you hear about us? If someone referred you, please list his or her name. *
We are looking forward to meeting you!
A copy of your responses will be emailed to the address you provided.
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