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Zoom Thru Latin

registration fORM

Parent Name*

Student Name*

Address

Parent Email*

Student Email

Parent Phone *

Student Phone

Student's Challenge Level*

Date of Birth*

Community Day*

Time Zone*

Community Break Weeks

Tell me about your student

My Preferred Days & Times Are: (Give me days/times that do not work as well)*

Choose Preferred Class:

Challenge A

Challenge B

Challenge 1

Challenge 2

Challenge 3

Product*

Live Tutoring Class $375

Your Virtual Guide for Homeschooling Latin

With Kerri Clark

Tel. (480)-266-8192
Michigan, 49506

United States

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