Test Prep Registration

Triple Threat Test Prep Registration Form

You can register and pay for a Triple Threat Test Prep course using this form. Please call if you have any questions. 404-755-4994 or email Register@nsoromma.org

Student's Email(Required)

Student's Name(Required)

First Last

Grade(Required)

School(Required)

Student's Phone

Parent's Name(Required)

First Last

Parent's Phone(Required)

Parent's Email that's checked regularly(Required)

Address(Required)

Street Address City State ZIP / Postal Code

Previous ACT or SAT scores (Date taken; Total and subtest scores)

Challenges

Has the student ever had learning or behavioral challenges or issues that required tutoring, counseling, special classes, 504 Plans, etc.? If yes, please describe briefly.

POLICIES, EXPECTATIONS & PERMISSIONS

Please indicate your agreement to the statements below by TYPING YOUR INITIALS in the text box. If you do not agree or give your permission, please state that you do not and/or give us a call.

Attendance and readiness(Required)

I understand that this is an in-person course. I will ensure that my teen attends classes on time and has a time and space for home assignments each day after class. Practice after class is critical for mastering the skills and improving test scores. They will need to bring pencils or pens, a basic calculator (a graphing calculator is NOT necessary), as well as the ACT Study Guide and Triple Threat Test Prep Manual that will be distributed in class.

Cancellations(Required)

I understand that CANCELLATIONS received in writing eight or more days prior to the first class will receive a refund of money paid minus a $50 cancellation fee. There are no refunds for requests received less than eight days prior to the first class. However, if the cancellation request is received prior to the first day of class, the amount paid can be applied to another test prep course offered within 12 months. I understand that there are no future applications of fees on or after the first day of class.

Refunds(Required)

I understand that there are no REFUNDS or future applications of fees on or after the first day of class. There are no refunds for missed classes and no make-up classes or class recordings offered.

Participation Permission and Release(Required)

I hereby grant PERMISSION for me/my child to participate in the Nsoromma School, Inc.’s Triple Threat Test Prep Program. I hereby agree to hold harmless and release Nsoromma, its officers, directors, employees, students and representatives (“Releasees”) from any claims of damage arising from my child’s participation in the program. I have signed this release with full recognition and appreciation of the risks of such activities, including risks associated with transportation to and from Nsoromma School, Inc.

Emergency Permissions(Required)

I agree that Nsoromma School, Inc. personnel are granted permission to authorize emergency medical treatment if necessary and that such action by persons shall be subject to the terms of this release. I understand that Releasees assume no responsibility for any injury or damage that might arise out of or in connection with such emergency medical treatment. I further agree that this consent and release shall be construed in accordance with the laws of the State of Georgia. If any term or provision of this consent and release shall be held illegal unenforceable or in conflict with any law governing this consent and release, the validity of the remaining portions shall not be affected.

Media Release(Required)

Certification(Required)

I certify that all of the information in this application is true and complete to the best of my knowledge and that I have not intentionally falsified or misrepresented any information.

How did you hear about us? Check as many as apply.(Required)

Email from Nsoromma School Triple Threat Test Prep

Email from another organization (In "Other" below, please tell us who sent the email)

I'm a returning student

I'm a sibling of a former student

A friend referred me. Please tell us the friend's name in "Other" below -- we like to thank those who make referrals for us!

Google Search

Information card/flyer I saw at _____ (In "Other" below, please tell us where you saw the card.)

Not sure

Other

Other and Other comments/questions

Use this space to enter "Other" responses from question above or any questions you may have.

Tuition Payment

Regular Tuition - $448

Springboard Scholar - $348

Returning Student - $348

Sibling of student in same class - $348

Verified PMBC Member - $338

Payment Method

MasterCard

Visa

Supported Credit Cards: MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name