Registration

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	Country

Student Name *

First Name Last Name

Student Email

example@example.com

Student's Grade 2019/20 *

Class Choice *

Student Name

First Name Last Name

Student Email

example@example.com

Student's Grade 2019/20

Class Choice

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 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.

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Please remit payment by paypal to drandmrst@gmail.com