Spell Like A Champion Course Registration
1. Parent's First Name
*
3. Parent's Last Name
*
4. Parent's Phone Number
*
5. Parent's Email Address
*
example@example.com
7. Street Address
*
8. City
*
Country
*
9. State or Region
*
10. Postal Code
*
11. Student's First Name
*
12. Student's Last Name
*
13. Age
*
16. Current Grade Level
*
17. Current School
*
Second Student (if applicable)
First Name
Last Name
Grade Level
Age
School
Please choose a section
*
Please Select
T, Th- 7pm-7:30pm (Spelling Champions Part 2, Section One)
T, Th- 7:35 pm-8:05 pm (Beginner's Spelling Class Part 2)
Registration Payment
*
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Registration for first student
for the Spell Like a Champion Course
$
100.00
Registration for second student
Second child is discounted to $50
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
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