Registration Form

*required fields
First Name *  
Last Name *  
Telephone Number *  
Email Address *  
Zip Code *  
Sex Male     Female*  
Date of Birth *
(month/day/year)		  
Reason for registering *  
Please Select a Program and Date* (dates are listed below each program)

Day of Remediation – Math

09/11/10
09/25/10
10/09/10
10/23/10
11/06/10
11/20/10
12/11/10

 
TABE™ Math Prep Class

09/18/10
10/02/10
10/16/10
10/30/10
11/13/10
12/04/10
12/18/10










 
SAT Math Test Prep Course

Course I starts on 09/12/10
Course II starts on 10/03/10
Course III starts on 11/02/10











 
Female Math Course
You MUST attend one of the following Orientations from 6:00 - 9:00 p.m.

8/31/2010 Orientation (including pre-Course testing)
9/2/2010 Orientation (including pre-Course testing)








 

  • I understand that if I arrive later than the indicated start time of the course/class/workshop for which I’ve registered, I will not be admitted.
     
  • I understand that the use of electronic devices (e.g. cell phones, ipods/mp3 players, laptop computers, etc.) is not permitted under any circumstances during class time; and that if I do use one of these forbidden devices I will be expelled from the class.

Print the completed form and bring it to class; it will be your admission “ticket.”

              

Registration Support: