Page 1 of 3
JSM - Registration Form
Full Name of Parent or Guardian responsible for Tuition
Full Name of Student enrolling
*
*
Student's Date of Birth
*
Contact E-mail
*
Contact Phone
*
Please provide your home or mailing address for billing purposes
*
Which course are you interested in enrolling?
*
Please advise of any existing medical conditions that may impact learning:
Choose a Term
*
Choose a Term
A
12 sessions
B
24 sessions
C
48 sessions
D
96 sessions
E
192 sessions
Next
