Georgia Milestones 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

Choose the class(es) you are registering for and indicate the student's current grade average(s):

Algebra I
Geometry
Physical Science
Biology
US History
Economics
9th Literature
11th Literature

Course Title:
Textbook Title:
To hold a seat in our course, a $50 deposit is required. 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?:

New Student Enrollment Fee: $65 (not applicable to previously enrolled TLC students)
Class Tuition: $205 per subject
Class Length: 6 hours

I understand and agree that:

  1. Enrollment begins after the new student enrollment fee (if applicable) and a $50 deposit has been paid to reserve a space in the class.
  2. The balance of $125 is due one week prior to the class date.
  3. The class fee may be paid by cash, check, or credit card. A $25 fee will be charged for all returned checks.
  4. Total Learning Concepts requires a 7 day notice for cancellation for this class. With this notice, the class may be rescheduled to another date or subject area and the deposit may be applied to another class or refunded. Without this 7 day notice, the deposit will not be refunded or credited.
  5. Each class is for students who are in the 8th through 12th grades.
  6. The number of students in each class will be a minimum of 4 and a maximum of 8. If a class has less than 4 students enrolled, we will proceed with the class as follows: 3 hours of class time for 1 student, and 4 hours of class time for 2-3 students. For classes with 4 to 8 students, the class will last 6 hours.
  7. Total Learning Concepts is committed to quality education. We will do everything to make sure each student succeeds. However, we accept no responsibility if the student fails to improve his/her course grades in school since we cannot control a student's willingness to study at home or a classroom teacher's quality of instruction.

I understand and agree to the above.

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Copyright © 2009 Total Learning Concepts, Inc. All rights reserved.
Revised: May 4, 2015
             
Copyright © 2015 Total Learning Concepts, Inc. All Rights Reserved