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Bronze Application Package

Bronze 6 Hour Package

Parent Name*
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Student Name*
First Last
Address*
Street Address City State ZIP Code
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High School*
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Please Select A Start Date (and time) for your 6 hour package:*
The final meeting times and subsequent schedule will be confirmed with the assigned counselor and the family. These are suggested times for you to consider.
Request a start date and time
Course Payment***
Cancellation Policy: Within 30 - 10 days of your start date, a 50% refund will be issued for cancellations. Within 9 days of your start date, the payment is nonrefundable.
- I agree to the Policies and Procedures and payment in full of $1,000.00

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