Student Registration Form

If you prefer to fill this form out and submit it online, please click here.

Otherwise, please print and fill out the form below and send it with payment to:

Kaplan Tutoring Services Inc.
    5 Karen Drive
    Barrington, RI 02806
    

Name of Participant_________________________________________________________

    Street Address______________________________________________________________

    City_____________________________________State_______Zip Code_______________

    Home Phone__________________________Email___________________________________

    School__________________________________________________________Grade_______

    Name of Parent/Guardian___________________Cell/Emergency Phone______________

    Course Title_____________________________________Total Enclosed_____________

    Date/Time/Place (if applicable)_____________________________________________

    Where did you hear about Kaplan Tutoring Services?__________________________