Georgia Milestones/"End of Course Test" Preparation Registration Form
Please provide the following contact information:
Today's Date: *
Student's Name: *
Parent's Names: *
Class Date:
Street Address *
Address (cont.)
City *
State/Province *
Zip/Postal Code *
Parent(s) Work Phone *
Home Phone *
E-mail *

Grade (choose one):


School Attending: *

Choose the type of course(s):

College Prep
Honors
Gifted
Advanced Placement

Course Title: *
Current Course Average:
Textbook Title: *
To hold a seat in our course, a $50 deposit is required, plus new student enrollment or returning fee, if applicable. Please provide credit card information below:
Name on Card: *
Card Number: *
Expiration Date: *

Choose the class times convenient for this student on each class day:

Saturday: 10 a.m. - 1 p.m.
Saturday: 2 p.m. - 5 p.m.
Saturday: 6 p.m. - 9 p.m.
Sunday: 1 p.m. - 4 p.m.
Sunday: 5 p.m. - 8 p.m.


How did you hear about Total Learning Concepts?: *

Class Tuition: $250 per subject
Class Length: 6 hours



Copyright © 2009 Total Learning Concepts, Inc. All rights reserved.
Revised: April 9, 2011
             
Copyright © 2015 Total Learning Concepts, Inc. All Rights Reserved