IQ Elite Complete Strategy & 4-Subject Breakdown Breaking 30 English & Reading Math & Science The 6 Hour Strategy Free Diagnostic Tutoring

Select the course you wish to attend:

Parent Name:

Student Name:

Street Address:

Street Address Line 2

City:

State:

Zip Code:

Parent's E-Mail:

Student's E-Mail:

Home Phone:

High School:

Current Year in High School:

Current ACT Cumulative Score if any): (1-36)

Current ACT English: (1-36)

Current ACT Math: (1-36)

Current ACT Reading: (1-36)

Current ACT Science Reasoning: (1-36)

Target ACT Score:

Universities/Colleges to which you plan to apply:

Current Cumulative High School GPA:

Would you be able to attend class on weekend days/weekend evenings/weekday evenings?

Additional comments

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(Ex: Have you taken an ACT prep class before? Does your school offer an ACT class? Do you have any special circumstances that need accommodating?)