Nov 2016 ACT Webinar Reg Form

CONTACT DR. CARLIN BY EMAIL - drcarlin@drcarlinstestprep.com OR BY PHONE - 517-803-5037

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Registration Form
ACT Prep Webinar - Fall Session

Course Dates:
Sundays
November 13, 20, 27 and December 4
All Sessions - 7:30-9:30 P.M. (EST)

Upon completion and submission of this registration form you will be directed to the payment screen. Please note that before the course begins you will receive an email detailing the process for logging in to the course sessions.
(PLEASE ENSURE EMAIL ADDRESS ACCURACY)

Important Note: You must also purchase the course textbook prior to the first course session.

* Indicates required field

Student's Name *

First

Last

Parent/Guardian Email (Confirming Registration) *

Please take care to enter a correct email address as all correspondence for this course will be sent to this address

Student's Email *

Please take care to enter the correct email address as all correspondence for this course will be sent to this address

Parent/Guardian's Name *

First

Last

Phone Number *

Student's School *

Student's Grade *

9th 10th 11th 12th

How Did You Hear About Dr. Carlin's ACT Prep Webinar? *

Student's High School Email Sent by Dr. Carlin's Test Prep Facebook Ad - flyer posted on Facebook with course info Google Search Friend or Family Returning Student - previously taken a course with Dr. Carlin Ace It Test Prep Podcast - College Ready with Dr. Carlin

Questions or comments for Dr. Carlin? *

Submit Registration and Proceed to Payment Screen