State Testing Academy Enrollment Form

PROGRAM OVERVIEW

HUMBLE University’s State Testing Academy is a six-week, virtual, small-group program designed to support 3rd–8th grade scholars in math and literacy while building effective test-taking strategies, time management skills, and confidence for state assessments. Live instruction is delivered in small groups to ensure personalized support and consistent progress.

Program Highlights
• 6-week virtual program
• Math & Literacy support
• Small-group instruction
• Mondays and Wednesdays from 6:00 - 7:15 PM (EST)
• Focused on state test readiness

IMPORTANT DATES & TUITION

Early Action Enrollment
January 15 – February 1

Tuition Options

Paid in Full: $225 due by February 1
Payment Plan: $100 deposit due by February 1
- $150 remaining balance due by February 15

Payment Terms
• Tuition deadlines must be met to maintain enrollment
• A 20% late fee will be applied to any payment not received by the stated due date
• Enrollment may be delayed or forfeited if payment obligations are not met

PARENT / GUARDIAN INFORMATION*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Preferred Method of Contact*

EmailText

SCHOLAR INFORMATION*

First NameLast Name

Current Grade Level*

State of Residence*

Does your scholar currently have an IEP or 504 Plan?*

YesNoPrefer not to share

If yes, would you like to share any accommodations that may support your scholar during virtual instruction?

What prompted your interest in the State Testing Academy?*

TUITION SELECTION*

Early Action – Paid in Full ($225 due by February 1)Early Action – Payment Plan ($100 deposit due by February 1; $150 remaining balance due by February 15

POLICIES & ACKNOWLEDGEMENTS*

I understand this is a 6-week live program with scheduled sessions on Mondays and Wednesdays from 6:00 - 7:15 PM (EST)I understand tuition deadlines and payment obligationsI understand spots are limited and enrollment is not confirmed until payment is received

NEXT STEPS & CONTRACT

What Happens After You Submit This Form

• You will receive a program contract and invoice within 24 hours of submitting this form
• Enrollment is finalized once the contract is signed and payment is completed
• Additional program details will be shared prior to the program start date

STAY CONNECTED WITH HUMBLE UNIVERSITY

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