Registration Form

Student's Information

Student's Name

First Name

Last Name

Student's Birthdate

YYYY

Student's Cell Phone (used for reminders)

(###)

###

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Student's Email (used for schedule reminders and session notes)

Student's Current School

Student's Graduation Year

Student's Current or Most Recently Completed Math Class Level?

What Best Describes your Student?

How did you hear about Vogel Prep?

Parent's (Guardian) Information

Parent's (Guardian) Name

First Name

Last Name

Contact Phone

(###)

###

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Contact Email Address

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do we need to be aware of any special accommodations or learning challenges for your student?

If you are registering for a private tutoring program - please explain your needs?

Preferred times and days available for tutoring (please provide a range of time as wide as possible so we can provide you the best options quickly)

Disclaimer: You will receive a confirmation email with instructions after our office checks for availability on your requested date.