Webinar & Scholarship Fund Enrollment Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.This form helps us gather the information we need to enroll your student in a College Prep Genius (CPG) course. It’s for internal use only and isn’t a sales receipt. Once your purchase is completed through CPG, your EMA/ESA, or other funding marketplace, we’ll match this form to your order and make sure your student is signed up in the right course format—whether virtual, in-person, or self-paced.Parent Name *First & LastParent Email *Student #1 Name *First & LastStudent #1 Email *Student #1 ID Number (if applicable)Student #2 NameFirst & LastStudent #2 Email Student #2 ID Number (if applicable)Student #3 NameFirst & LastStudent #3 EmailStudent #3 ID Number (if applicable)Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Bootcamp Type *--- Select Choice ---SAT/PSAT Self-Paced VideosSAT/PSAT Live Online/Virtual ClassSAT/PSAT In-Person BootcampCLT Live Online/Virtual ClassCLT In-Person BootcampPlease select the class type you purchased Number #3 Parent SAT/PSAT or CLT Live-Virtual Bootcamp Selection *Please let us know which available bootcamp you’d like to be enrolled in. You can view all current bootcamp options on our website here: collegeprepgenius.com/shop. Example: SAT/PSAT 8-week Live Virtual Bootcamp, July 8-August 26, 9:00am - 10:30am (Central)In-Person Bootcamp Selection *Please let us know which specific one you are joining. Include the city/state, start date, and host name.Your CPG Course purchase: *--- Select Choice ---I have purchased with my ESA/EMA/ FundsI will purchase with my ESA/EMA/ FundsI have purchased from CPG WebsiteI will purchase from CPG WebsiteFunding/Scholarship Name *Date of Purchase *How did you hear about us? *I would like to receive freebies & promotional emails from College Prep Genius. *Yes!Submit