Educational Partnership Registration

Parent Name (Required)

7mx2t2mh9urn

Student Name (Required)

Grade (Required)

Administrator's Name

Administrator's Email

Teacher's First Name (Required)

Teacher's Last Name (Required)

E-mail (Required)

Phone (Required)

School (Required)

School District (Required)

Days Additional Teacher will be Attending:

You will be charged $50 per teacher per day.

Tuesday October 29, 2019

Friday January 31, 2020

Saturday February 1, 2020

Cardholder Name (Required)

Credit Card # (Required)

Visa MasterCard American Express Discover

Expiration Date (Required)

Security Code (Required)

Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Billing Zip Code (Required)

Your total payment will be

Educational Partnerships