Student Registration Form
2022 Spring Semester
Student's Name
First Name
(Optional) Korean Name
Last Name
Current Grade
Gender
Please Select
Male
Female
N/A
Student Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Email
*
example@example.com
Phone Number
*
Emergency Contact Name
First Name
Last Name
Emergency Contact Number
Relation
Course
Please Select
SAT/ACT
College Essay Crash Course
SSAT/ISEE Test
English 3
English 4
English 5
English 6
English 7
English 8
English 9
Advanced English 10/11
Pre-Algebra
Algebra I
Algebra 2
Geometry
Pre-Calculus
AP Calculus
Intro Biology
Intro Chemistry
Intro Physics
Other AP class
Please select course(s)
N;/umber of weeks you are signing up for.
20 weeks
Other
Select the format:
*
In-person (first-come-first-placed)
Online/Distance learning
*Our new location is: 317 Harrington Ave, Closter NJ, 07624
Private Tutoring
Please Select
Subject
Admissions Consulting
Please Select
4 years University/College
West Point & other Service academy
Specialized Schools
Private High Schools
Universities in Korea
Extracurricular Activities
Leadership Academy
Parent Workshop
Additional Comments
Today's Date
-
Month
-
Day
Year
Date
Parent's Signature (Please type)
Submit
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