Power Courses Registration Form

Student Name *

Parents Names *

Student's Cell Phone Number *

Parents' Phone Numbers *

Fax Number/Other Contact Numbers

Address *

City *

State *

Zip Code *

Parents' Email Address *

Student's Email Address *

Student's Birthdate *

Student's Graduation Year *

Highschool Name *

Current GPA *

PSAT Scores: Reading/Writing and Math

SAT Scores: Reading/Writing and Math

ACT Scores: English, Math, Reading, Science or Composite

Extra Curricular Activites *

Which colleges are you interested in? *

Power Course Preference *

2024 Late Fall Power ACT Evening Course: October 26 - December 11 (Monday / Wednesday evening classes (6:30 pm to 8:30 pm), Saturday morning practice tests)

2024 Fall Power ACT Evening Course: September 7 - October 23 (Monday/ Wednesday evening classes (6:30 pm to 8:30 pm), Saturday morning practice tests)

How did you hear about us? *

A family member or friend. If so, who?

Your guidance/college counselor. If so, who?

Your school.

Another standardized prep course.

You know Alex or a Power Course team member.

Online.

Please specify names here. Please specify names here.