Rock the ACT - Spring 2016

Rock the ACT Registration

Thanks for registering for our Rock the ACT course! Classes are Sunday night from 4 PM to 6 PM, beginning January 31, and run for nine weeks. This includes a final two-hour review session on the Thursday night before the test!

Please fill out all the information below to secure your child a spot in our class. For online registration, a major credit or debit card is required. All payments are processed securely through PayPal.

Once you complete your registration, you will receive a confirmation e-mail with your registration details. Please contact us at (219) 595-0920 with any questions you may have.

Thanks again for being a part of the Academic Pointe family!

Name of Parent*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Home Phone*

Email*

Number

How did you hear about us?

Friend/Family Print Ad Radio Ad Postcard Mailing I'm a previous customer.

Name of Child*

First Name

Last Name

Child's School

Child's Most Recent Math Grade*

Child's Most Recent English Grade*

Total Amount Due $

Credit Card*

By submitting your registration form online, you agree to hold harmless The Academic Pointe, Inc, Munster Math, LLC, 45th Street Properties, LLC, and any and all of its employees and contractors from any and all liability resulting from the participation of your child in The Academic Pointe, Inc. Rock the ACT program. Furthermore, The Academic Pointe, Inc. reserves the right to remove a student from the SAT/ACT program, without warning and refund, due to a failure to follow the general rules and regulations set forth by The Academic Pointe, Inc. The Academic Pointe, Inc. is not required to issue a refund for any circumstance, and due to the nature of our business, refunds shall not be issued due to cancellations or for any other reasons once registration and payment have been submitted.*

I agree.