Private Consulting Services Registration

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Preferred dates and times: *

Email: *

Important: Course communication, login ID, and other relevant parent/student information will be sent to this email address. Please ensure that you check your email regularly.

How did you hear about us?:

Student Information

Student First Name: *

Student Last Name: *

Gender:

Current Grade:

Date of Birth: * DD/MM/YYYY

Age:

School Presently Attended:

Anticipate Enrolment Date?: * MM/YYYY

Has the student written the SSAT?
If not, has the student written the PREPSKILLS^® Diagnostic or Simulation SSAT?

Written the SSAT:

Diagnostic or Simulation SSAT:

What are the student's top 3 choices for private schools?

Top 3 choices:

Mother Information

Mother's First Name: *

Mother's Last Name: *

Mother's Occupation:

Mother's Email: *

Home Phone Number: *

Business Phone Number:

Cell Phone Number:

Father Information

Father's First Name: *

Father's Last Name: *

Father's Occupation:

Father's Email: *

Home Phone Number: *

Business Phone Number:

Cell Phone Number:

Mailing Address

Mailing address: *

City and Province: *

Postal Code: *

Additional Information

Comments:

Tuition & Payment Information

Tuition: $400 + HST
(Fee per student for Initial Consultation with the president (1 hour);
additional consulting will be charged according to specifications required.)

Cheque / Money Order
Payable To: PREPSKILLS INC.
Mailing Address: 250 Merton Street, Suite 404, Toronto, Ontario, M4S 1B1
FULL PAYMENT MUST BE RECEIVED AT THE TIME OF REGISTRATION

Credit Card payments: please contact the PREPSKILLS office at (416) 200-7728
or toll free 1-866-973-PREP (7737) for processing.

Type of Card:

Name on Card:

Card Number:

Expiry Date: MM/YYYY

For more information please phone (416) 200-7728

I assume full responsibility for payment. I have read and acknowledged the PREPSKILLS INC. policy including prepayment, no refunds or make up lessons as outlined.

I agree to the terms and conditions set forth by PREPSKILLS Inc.

I recognize and accept that no reputable organization can make any guarantee as the development of skills or the results of future tests.

I hereby release PREPSKILLS INC. or staff and the location from all claims, demands, losses, actions suits or proceeding rising out of the participation of the applicant named in any facility or at any location where the program/tutoring is being held.

Your invoice will be issued to you via email upon submitting this online registration.

Math question: * 12 + 3 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.