* Required

Student First Name*required

Student Last Name*required

Homeroom*required

Parent/Guardian First Name*required

Parent Guardian Last Name*required

Parent/Guardian Phone Contact 1*required

Parent/Guardian Phone Contact 2

Parent/Guardian Primary Contact Email*required

Parent/Guardian Secondary Contact Email

Emergency Contact Information - Name and telephone number*required

Allergies/Medical Concerns

Dismissal Preference*

Car Pick Up  CARES  Concurrent Classroom 

Test Prep Fee $450.00

Charge: 0.00

Total Purchase

Please send a confirmation email to the address below*: