Take Me Home! Order Form
 

Attention!
Please note: these Enrichment Courses are currently available only to students within our local service area!
Ordering procedure: Please fill out the following information and click on "Send it to A+" button to submit it. After we receive your order our representative will contact you by telephone to discuss your needs and payment options. Thank you for your order, and we look forward to helping you with any of your educational needs!
Information
Student: (Fields marked by asterisks are required)
First Name*:
Last Name*:
Address*:
City*:
State*:
Zip*:
Country*:
Home Phone*:
Email:
Age*:
Current Grade Level*:
School:
Parent or Guardian: (Following information is required if student is under 18)*
First Name:
Last Name:
Home Phone:
Work Phone:
Fax:
Email:
Mailing Address: (if different from student's address)
 
Please tell us which courses you are interested in, and type any additional comments in the box below:

      

 
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Please note:
A+ Educational Services may cancel any class for any reason in which case a complete refund will be issued. Otherwise all fees are non-refundable.