Register

Thank You for considering The Grade. To apply for the program, please complete the registration and payment sections below.

The priority deadline is September 7, 2018. If an application is submitted after this date, we cannot guarantee that you will be assigned a mentor in time for the first session.

The Grade offers early bird rates for early applications. If a registration is submitted before August 27, 2018, the charge is $400. If the form is submitted after this date but before September 3, 2018, the charge is $425. The full rate is $550. For more information, please go to link below.

to make a payment for the program, please go to the payments page

The Grade also accepts donations. If you would like contribute to the program, please go the the donations page.

Student Information

Student Name *

Student Name

First Name

Last Name

Date of Birth *

Date of Birth

YYYY

Grade Level Entering in the Fall *

School *

Student E-mail *

Home Phone *

Home Phone

(###)

###

####

Student Cell (if applicable)

(###)

###

####

Was the student in The Grade last year? *

Yes

If the answer to the above was 'No', how did you hear about The Grade?

Parent Information

Father Name *

Father Name

First Name

Last Name

Father E-mail *

Father Cell Phone *

Father Cell Phone

(###)

###

####

Mother Name *

Mother Name

First Name

Last Name

Mother E-mail *

Mother Cell Phone *

Mother Cell Phone

(###)

###

####

Address

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Sibling Information (Optional)

If you would like to be contacted for similar programs for your other children, please feel free to fill out the fields below:

Sibling 1

First Name

Last Name

Sibling 1 DOB

YYYY

Sibling 1 Gender

Sibling 2

First Name

Last Name

Sibling 2 DOB

YYYY

Sibling 2 Gender

Sibling 3

First Name

Last Name

Sibling 3 DOB

YYYY

Sibling 3 Gender

Sibling 4

First Name

Last Name

Sibling 4 DOB

YYYY

Sibling 4 Gender

Sibling 5

First Name

Last Name

Sibling 5 DOB

YYYY

Sibling 5 Gender

Sibling 6

First Name

Last Name

Sibling 6 DOB

YYYY

Sibling 6 Gender

Release

MEDICAL & PHOTO RELEASE: By entering my name below, I understand that I am signing as a parent or legal guardian of the applicant. In signing, I authorize The Grade staff to seek medical assistance for my son, should the need arise. In addition, I authorize any photography that includes my son to be used for the purpose of promoting The Grade. I understand that such photography remains property of the Grade *

If you have any additional comments for the program directors, please mention them here.

to make a payment for the program, please go to the payments page

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