Individual Clas PIF Form

Individual Classes

Enroll and Pay
Who did you speak with*

RaphaelMary GraceOfeliaJemarthQueenShannenSomeone in chat (Emma, AI Bot)I didn't speak with anyone
Need NCAA Clearance*

YesNo
Student Information
First Name*
Last Name*
Date of Birth*

MonthDayYear
Gender*

MaleFemale
Social Security*
Ethnicity*

HispanicNon-Hispanic
Race*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Grade
Grade Level
Phone Number*

Country CodeArea CodePhone Number
E-mail*
Have you taken the prerequisite for this class?*

YesNo
Please refer to this List of Courses Available and select the courses you wanted to take on dropdown below (You can take up to 3 1/2 course credit)
Course Selection [ ** Can type in the Course title on the "Filter" box for easy searching]*
Parent Information*

First NameLast Name
Parent E-mail *
Phone Number*

Country Code (+1)Area CodePhone Number
Please provide your school information to send your credits.
Name of School*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date School Needs Your Transcript*

MonthDayYear
Pay for your Individual Class(es) Below:

Registration is $100.00 plus your tuition.

24/7 Unlimited Tutoring (1-time fee) $100.00 (Optional)

Individual Class Fees

1/2 Credit (or 2 Quarters Hrs) = 0.50 (1/2 credit) $150.00

1 Credit (or 4 Quarters Hrs) = 1.00 Full Credit $300.00
Parent / Guardian Type Name to Enroll Your Child*

First NameLast Name
Upload your Parent Phot ID or Fax to TSA*

Amount Due*

Registration$100.00

Registration fees are valid for 10 months. Please uncheck this if you have paid within the 10 month period

1 Full Credit$300.00

How many credits do you need

1/2 Credit$150.00

How many credits do you need

24/7 Unlimited Tutoring$100.00

*For 13yrs old and above only

Transcript$10.00

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Subtotal $0.00Tax $0.00Total $0.00

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Credit Card Number	Security Code
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Individual Classes