Registration Form — Eastside Education

Summer Camp Registration Form

Today's Date *

Today's Date

MM

DD

YYYY

Camps *

Mon-Fri 9am-3pm

5-days Competition Math: 6/24-6/28 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

5-days Competition Math: 8/5-8/9 for 5th-8th grade $600

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 2017-2018 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

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

Summer Class Registration Form

Today's Date *

Today's Date

MM

DD

YYYY

Class *

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

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

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

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 2017-2018 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

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

Summer Camp Registration Form

Summer Class Registration Form

2018-2019 Class Registration Form

Private Tutoring Request Form