Small Group Class Registration

Student's Information

Student's Name

First Name

Last Name

Student's Cell Phone (# will be used for session reminders)

(###)

###

####

Student's email address (used to send schedules and session notes)

Student's Birthdate

YYYY

Student's Current School

Graduation Year

Which Option Below Best Describes your Student?

If New Client above, is this your 1st Child Going Through the College Admission Process?

What is your student's current Math class?

How Did You Hear about Vogel Prep?

Parent's (Guardian) Information

Parent's (Guardian) Name

First Name

Last Name

Contact Phone

(###)

###

####

Contact Email Address

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Select Small Group Class of Interest

Message to the Director

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

Disclaimer:

By providing your phone number to Vogel Prep, you agree and acknowledge that we may send text messages to your wireless phone number for any purpose. Message and data rates may apply.

You will be able to opt out of this messaging service by replying “STOP” at any time. For more information on how your data will be handled, please read privacy policy below.

Privacy Policy: No mobile information will be shared with third parties or affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.