Course AND Practice Test Registration Form 2011-2012 Step 1: Determine the desired course location and dates Step 2: Determine the desired Practice test date and location Step 3: Print and complete this form; mail to SAT Prep [mailing address below] The course and practive test fee is $364, which includes the textbook and class materials. A portion of this fee goes directly to the local PTSA or sponsoring group to support student programs. Course cancellations: A $25 fee will be charged for cancellations made 7 days prior to the start of the course. There is a $50 fee if a cancellation is made within 6 days of the first class date.

Student first name
Student last name
Date of registration
SAT Prep Course location
Practice Test location
Home school name
Home address
City: x State: x Zip: x
Parent full name
Email address
Parent home phone
Parent work phone
Method of payment (please circle one)	Check enclosed Credit or Debit Card
Credit card number
Credit card expiration date
Credit card billing zip code
Full name on credit card
If paying by check, please make payable to "SAT Prep".

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Mail to: SAT PREP P. O. Box 883 Kirkland, WA 98083
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