College Study Strategies Registration Form / Rising College Freshman & Beyond
Please provide the following contact information:
Today's Date:
Student's Name:
Parent's Names:
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Parent(s) Work Phone
Home Phone
E-mail

College Attending:
Choose One:
 
Student's Academic Strengths:
Student's Academic Weaknesses:
Month in which you'd like to begin:
If so, please explain:

Choose the days and times that are the most convenient:

Monday Afternoon
Monday Evening
Tuesday Afternoon
Tuesday Evening
Wednesday Afternoon
Wednesday Evening
Thursday Afternoon
Thursday Evening
Saturday Morning
Saturday Afternoon
Sunday Afternoon

How did you hear about Total Learning Concepts?:

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:

Course Tuition: $330
Course Length: 8 hours
Materials Fee: $35



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