Registration Form — Eastside Education

Workshop Registration Form

Today's Date *

Today's Date

YYYY

Workshop *

AMC 8 Fri & Mon 11/9/18, & 11/12/18 @9am-3pm $200

AMC 10/12 Mon 1/21/19 @9am-3pm $100

AMC 10/12 Mon 1/28/19 @9am-3pm $100

AP Physics 1 Tue-Fri 4/9/19-4/12/19 @11-1pm $320

AP Physics 2 Mon-Thu 4/8/19-4/11/19 @ 9-11am $320

AP Chemistry Mon-Thu 4/8/19-4/11/19 @11am-1pm $320

AP Calculus AB Mon-Thu 4/8/19-4/11/19 @6:30-8:30pm $320

AP Calculus BC Mon-Thu 4/8/19-4/11/19 @2:00-4:00pm $320

Need after care?

For whole day workshop only.

Yes

Student's Name *

Student's Name

First Name

Last Name

Student's Email Address

Student's Phone #

(###)

###

####

School *

Grade *

Parent's Name *

Parent's Name

First Name

Last Name

Parent's Email Address *

Parent's Phone 1 *

Parent's Phone 1

(###)

###

####

Parent's Phone 2

(###)

###

####

Home Address *

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Message

Method of Payment *

Check

Bank Pay/Transfer

PayPal(credit card is not accepted)

Credit Card(3% surcharge)

has been successfully submitted. Your seat will be secured once we receive your payment. Thank you!

Your seat will be secured once we received your payment.

Payment instructions:

- Check payable to Eastside Education and mail or drop it to

2721 152nd Ave NE Redmond, WA 98052

- PayPal or Bank Pay/Transfer payable to eastsideeduwa@gmail.com

2019 Summer Camp Registration Form

Today's Date *

Today's Date

YYYY

Camps *

Mon-Fri 9am-3pm

5-days Competition Math: 6/24-6/28 for 5th-8th grade $600

5-days Competition Math: 8/26-8/30 for 5th-8th grade $600

5-days Foundation/Competition Math: 7/8-7/12, for 2nd-8th grade $500

5-days Foundation/Competition Math: 7/15-7/19, for 2nd-8th grade $500

5-days Foundation/Competition Math: 7/29-8/2, for 2nd-8th grade $500

5-days Foundation/Competition Math: 8/5-8/9, for 2nd-8th grade $500

Extended Care *

3-6pm $25/day

None

Monday

Tuesday

Wednesday

Thursday

Friday

Student's Name *

Student's Name

First Name

Last Name

School *

Grade *

Answer must base on 2018-2019 school year.

Grade of Math

For math camp enroll only. Answer must base on 2018-2019 school year.

Parent's Name *

Parent's Name

First Name

Last Name

Parent's Email Address

Parent's Phone 1 *

Parent's Phone 1

(###)

###

####

Parent's Phone 2

(###)

###

####

Home Address *

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact *

Emergency Contact

First Name

Last Name

Emergency Contact Phone *

Emergency Contact Phone

(###)

###

####

Message

has been successfully submitted. Your spot will be secured once we receive your payment. Thanks!

Your seat will be secured once we receive your payment.

Payment instructions:

- Check payable to Eastside Education and mail or drop it to

2721 152nd Ave NE Redmond, WA 98052

- Bank Pay/Transfer or Paypal payable to eastsideeduwa@gmail.com

2019 Summer Class Registration Form

Today's Date *

Today's Date

YYYY

Class *

AMC8/10: 6/25-8/27, Tue @6:30-8pm, $350

AMC 10/12: 6/26-8/28, Wed @6:30-8pm $400

Gifted Geometry: 6/25-8/27, Tue & Thu 6:30-8pm $700

Java Programming: 6/24-8/22, Mon & Wed @3:30-5pm $700

Trigonometry 6/25-8/27 Tue & Thur @6:30-8pm $700

ACT Prep: 6/24-7/12 Mon-Fri @6-8pm $1250

SAT Prep: 7/29-8/22, Mon-Thru @6-8pm, $1400

Student's Name *

Student's Name

First Name

Last Name

School *

Grade *

Base on 2018-2019 school year

Math Level

For math class enroll only. Answer must be base on 2018-2019 school year record.

Parent's Name *

Parent's Name

First Name

Last Name

Parent's Email Address

Parent's Phone 1 *

Parent's Phone 1

(###)

###

####

Parent's Phone 2

(###)

###

####

Home Address *

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Message

has been successfully submitted. Your seat will be secured once we receive your payment. Thank you!

Your seat will be secured once we receive your payment.

Payment instructions:

- Check payable to Eastside Education and mail or drop it to

2721 152nd Ave NE Redmond, WA 98052

- Bank Pay/Transfer or Paypal payable to eastsideeduwa@gmail.com

2019-2020 Class Registration Form

Today's Date *

Today's Date

YYYY

Term *

Fall Semester 9/4-1/26

Spring Semester 1/27 - 6/22

Class *

18 sessions/class/semester

Math 2/3 - Sat 9:00-10:30 am $660

Math 4/5 - Tue 7:00-8:30 pm $660

Pre-Algebra - Sat 3:30-5:00 pm $660

Algebra I - Tue 6:30-8:00 pm $660

Algebra II - Thu 6:30-8:00 pm $660

Competition Math 1 - Fri 5:00-6:30 pm $660

Competition Math 2 - Fri 6:30-8:00 pm $660

Competition Math 3 - Thu 7-8:30pm $660

Competition Math 4 - Tue 7:00-8:30 pm $660

Competition Math 5 - Wed 6:30-8:00 pm $660

Competition Math 6 - Sun 2:30-4:00 pm $660

English 4/5 Wed 6:30-8:00 pm $660

English 5/6 - Fri 6:00-7:30 am $660

English 7/8 - Sat 11:30-1:00 pm $660

ACT/SAT Prep - Sat 12-2 pm $1600

AP Java Programming - Sun 1:00-2:30 pm $700

Student's Name *

Student's Name

First Name

Last Name

School *

Grade *

Answer must base 2018-2019 school year

Math Level

For math class enroll only. Answer must base 2018-2019 school year record.

Parent's Name *

Parent's Name

First Name

Last Name

Parent's Email Address *

Parent's Phone 1 *

Parent's Phone 1

(###)

###

####

Parent's Phone 2

(###)

###

####

Home Address *

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Message

Method of Payment *

Check

Bank Pay/Transfer

PayPal(credit card is not accepted)

Credit Card(3% surcharge)

has been successfully submitted. Your seat will be secured once we receive your payment. Thank you!

Your seat will be secured once we received your payment.

Payment instructions:

- Check payable to Eastside Education and mail or drop it to

2721 152nd Ave NE Redmond, WA 98052

- Bank Pay/Transfer or Paypal payable to eastsideeduwa@gmail.com

Private Tutoring Request Form

Today's Date *

Today's Date

YYYY

Tutoring Subject *

SAT

ACT

SSAT/ISEE

Math(school)

Math(competition)

English

Physics 1

Physics 2

Chemistry

Biology

History

SAT 2 subject

Java Programming

Other

Detail about this tutoring

Please Includes the level of the subject.

Student's Name *

Student's Name

First Name

Last Name

School *

Grade *

Parent's Name *

Parent's Name

First Name

Last Name

Parent's Email Address

Parent's Phone 1 *

Parent's Phone 1

(###)

###

####

Parent's Phone 2

(###)

###

####

Home Address *

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

has been successfully submitted. Thank you!