Text Box: BRENDON FLYNN S.A.T. PREP REGISTRATION Weston Town Center Executive Suites 1792 Bell Tower LaneWeston, FL 33326 www.flynnsat.com, (954) 290-2787, flynnsat@aol.com <—— back Student Name: _________________________________________________________________ GRADE: _____ D.O.B. ____/_____/_______ GENDER: ____ High School: __________________ Parent(s) Name(s): ______________________________________________________________ Parent(s) Email(s): ______________________________________________________________ Student Email: _________________________________________________________________ Address: _____________________________________________________ Zip: _____________ Primary parent phone: HOME: _______________________ CELL: ________________________ Student cell phone (required for emergency contact): _______________________________________ Highest Entering Scores: __SAT __PSAT: Reading _______ Math________ Writing _______ (please provide a copy of all score reports for 1st lesson, if possible) Which class date/time are you registering for? ___________________________________ Special request/concerns: ________________________________________________________ Current/Most Recent Math Class/Level: ____________________ Your Grade in this class: ________ Current English Class Level: ____ Regular ___ Honors ___ AP Your Grade in this class: _______ Is test anxiety a problem for you? _____________ Weighted GPA _______ Have you taken any previous SAT classes? ______ With whom? ____________ Increase: _____________ Please let us know anyone specific who may have referred you to us so we may thank them: _____________________________________________________________________________. Have you seen our ad media in: ___ Weston Gazette? ___ CBHS Newspaper? ___ Online Searches? ___ Mailers Please drop off (8:50am-5:10pm) or mail this form (with a $400 deposit) to the address above to secure your spot. Openings will be filled on a first-come, first-served basis. All classes fill at 8 students. By signing below, I acknowledge that I have read and understood the “payments/policies” section on www.flynnsat.com, especially the sectionss about make-up lessons and the score guarantee.