Sylvan SAT Prep Enrollment Form

Student:_______________________________ Date of Birth:___________ Grade: _____ Phone (H):__________________

Parent/Responsible Party:________________________ Cell Phone: ______________ Phone (W):____________________

Address:_________________________________________________________________Email:________________________

Most Recent SAT scores: Math_____Verbal______Writing______ Date of next scheduled SAT _____________________

Please check one:

For the 10/10/2009 SAT:
7/25 – 10/03 Saturdays 10:00 AM – 2:00 PM
For the 11/7/2009 SAT:
9/17 – 11/05 Tuesdays 3:30 PM – 5:30 PM and Thursdays 4:30 PM – 6:30 PM
For the 12/5/2009 SAT:
9/19 – 11/21 Saturdays 10:00 AM – 2:00 PM
For the 1/23-2010 SAT:
12/3 – 1/21 Tuesdays 3:30 PM – 5:30 PM; Wednesdays (12/23, 12/30) 4:30 PM – 6:30 PM
and Thursdays (12/3, 12/10, 12/17, 1/7, 1/14, 1/21) 4:30 PM – 6:30 PM
For the 3/13/2010 SAT:
1/9 – 3/6 Saturdays 10:00 AM – 2:00 PM
For the 5/1/2010 SAT:
3/11 – 4/29 Tuesdays 3:30 PM – 5:30 PM and Thursdays 4:30 PM – 6:30 PM
For the 6/5/2010 SAT:
3/27 – 5/29 Saturdays 10:00 AM – 2:00 PM

SAT Prep Course Fee: $795.00

Payment: Check Visa, MC, or Discover Number: _______________________________ Exp. Date: _____________

Signature of Responsible Party: ___________________________________________________________ Date: _____________

Agreement – I have enrolled in this course solely for the purpose of preparing for the SAT. All techniques and materials are the property of Sylvan Learning Center. I
agree that no copies of these materials will be distributed to third parties.

Responsibility – Regular attendance, participation, and homework are required for students to learn and apply strategies.

Content – Sylvan SAT Prep is a strategies-based course and students should not expect to receive instruction in English or Math. Courses in Reading, Math, Algebra,
Study Skills and Advanced Reading Skills are available for students who want to improve in these areas.

Schedule – Sylvan reserves the right to alter the course schedule and/or content should it prove necessary. A minimum of 6 students will be required to hold the class.

Behavior – We reserve the right to dismiss, without refund, any student who is disruptive in class.

Guarantee – If, after enrolling and attending the first session, you are not convinced that Sylvan SAT Prep is the best program for you, then simply notify us within 48
hours of your first session and return your materials for a full refund. Refund requests made after 48 hours of attending the first session will not be honored.

Additional Information: Courses are filled on a first-come, first-served basis. Tuition must be paid in full to reserve a seat. If we receive an enrollment form
subsequent to the requested class being filled, we will notify you by phone to discuss alternatives.

To Enroll, please return completed form with payment to:

Sylvan Learning Center
5415 Camden Ave.
San Jose, CA 95124
(408)448-8100