E.D.S. Group Class

 Registration Form  

1.        Please mark a check in the box next to the class for which you are enrolling.

2.        Fill out information below.

3.        Mail back a copy of this registration form with your deposit of $150.00 which is refundable until 2 weeks before the first class.

4.        Classes fill quickly, so mail your registration back as soon as possible.

5.        Class dates are subject to change.  You will be notified in advance if that occurs.

 

AutoShape:     Plantation		Weston SAT group class – Please  circle SAT class you wish to attend:             A   1   2         3   4

 SAT private lessons – minimum 16 hours

 SSME – Please  circle class you wish to attend:      A   B   C   D   E       

 HSPT  group class – Please  circle HSPT class you wish to attend:      A     B    

 

SAT students –  previous PSAT or SAT scores:                                                                 Unweighted GPA                      

Date of test                         Verbal                      Math                       Writing                       Weighted GPA                      

 

STUDENT NAME:                                                                                     HOME PHONE:                                     

 

ADDRESS:                                                                                                                                                           

 

CITY:                                                                                                                 ZIP:                                             

 

SCHOOL:                                                                                                    GRADE:                                             

 

MOTHER:                                                                      WORK PHONE:                                                               

 

CELL PHONE:                                                                FAX:                                                                                

 

FATHER:                                                                      WORK PHONE:                                                                

 

CELL PHONE:                                                                FAX:                                                                                

 

Primary Contact Person:      ˙ MOTHER      ˙ FATHER

E-MAIL                                                                                                                                                      

 

DRIVER’S LIC.                                                                                                                                           

 

REFERRED BY:                                                                                                                                                    

 

For all classes:       $150.00 deposit due with registration;

Except for private lessons, balance due by first class

 

Mail this form with your deposit of $150.00 (payable to E.D.S.) to:

E.D.S. 

 

7445 NW 4th Street 

Plantation, FL 33317

 

Phone (954) 584-9817       

Fax (954) 792-5776