Registration
Mrs Judith Science Classes
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian email
*
example@example.com
Parent/Guardian Phone
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Name
*
First Name
Last Name
Student Email
example@example.com
Student's Grade 2020/21
*
8th
9th
10th
11th
12th
Class Choice
*
Anatomy & Physiology
Biology
Chemistry
Student Name
First Name
Last Name
Student Email
example@example.com
Student's Grade 2020/21
8th
9th
10th
11th
12th
Class Choice
Anatomy & Physiology
Biology
Chemistry
I understand that I must fill out both the registration form for Mrs Judith classes and the registration form on the central website for Jackson Tutorial. I also understand that I must pay my first month tuition($42) for my class which is outlined on the class page of Mrs Judith's web page and the tutorial fee for Jackson Tutorial which is $25 and non refundable. My spot in the classes is not secure until these things have been done. I understand that if I do not cancel my participation in Mrs Judith's classes before July 1, I forfeit any money paid up to that point and any money paid after that point is also non-furndable. I understand that all tuition is due on the first of the month and any tuition not paid by the 10th of the month is considered late and will be charged a $10 late fee. I also understand that tuition is due regardless of attendance.
Clear
Please remit payment by paypal to
drandmrst@gmail.com
Submit
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