Service & Payment Plan*

Fundamentals July - Math

Price

$399.00

Guardian First Name*

Guardian Last Name*

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Student First Name*

Student Last Name*

Student Email*

Student Phone Number*

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Student High School*

Graduation Year*

What are the student's pronouns?*

Completed Math courses (select all that apply)*

Geometry

Algebra 2

Precalculus

Calculus

If already decided, which test is the student planning to take?*

ACT

SAT

Not sure

Does the student receive accommodations in school (IEP, 504, etc.)*

Yes

No

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Is there anything else you think we should know?

Please list any siblings and their graduation years.

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I understand and agree to be charged for an appointment if not cancelled within 24 hrs. of the scheduled time

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Payment amount:

$399.00

Total to pay:

$399.00

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