$2200 for Full Year
Installment option available
Registering for
*
September 08 2024 - May 09, 2025
Back
Continue
Student's Full Name
*
First Name
Last Name
Student's Date of Birth
*
-
Month
-
Day
Year
Grade
*
Please Select
K
1
2
3
4
5
6
7
8
School Info
*
School Name
School District
Mother Full Name
*
First Name
Last Name
Mother Email
*
example@example.com
Mother Phone Number
*
Please enter a valid phone number.
Father Full Name
*
First Name
Last Name
Father Email
*
example@example.com
Father Phone Number
*
Please enter a valid phone number.
Home Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Authorized Pickup
*
Mother (as mentioned above)
Father (as mentioned above)
Other
Relation to the child
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Mandatory Pickup/Dropoff Policies and Procedures
*
Payment
The competition participation fee is not included in the courseprice.
*
prev
next
( X )
VEX IQ Robotics
Pay in Full
$
2,200.00
for each
year
VEX IQ Robotics
Two Installments
$
1,100.00
for each
six months
VEX IQ Robotics
Three Installments
$
733.34
for each
three months
Email
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Consent & Acknowledgement
Please fill all the required fields
Liability Waiver
*
Refund Policy:
*
Notification
*
*
Date of Consent
*
/
Month
/
Day
Year
Date
How did you hear about us?
*
Back to School Fair
Facebook
Email
Whatsapp
Friend
Representative called
Received postcard
GEM Newsletter
Instagram
Other
SUBMIT
How did you hear about us?
*
Additional Notes/Comments
Should be Empty: