Reicher CLASS ENROLLMENT FORM

Parent:   _______________________________________________

Student: _______________________________________________

Address:______________________________________________________

     ______________________________________________________

Phone:   _________________________________________________________

Email:    _________________________________________________________

Class:___ACT    or     SAT  _______(Circle One)

Class Dates:________________________________________

Times of class:_____________________________________


Cost:  $220Paying by check ___  or credit card(add info below) ____


CLIENT SIGNATURE:  _______________________________Date:____________

I authorize Knowledge Guides to bill my credit card for this class.
ACCOUNT NUMBER: ___________________Amount:  _____________
EXPIRATION DATE: ______________NAME ON CARD:______________   Type of Card: __________(V, MC, D, Amex)
Signature:____________________________



Print, complete, and mail or fax to our office.  Fax number is 817-451-6203