2008 Fall Group

 

R E G I S T R A T I O N  F O R M

 

VERY IMPORTANT, PLEASE NOTE...

A non-refundable $100 deposit PER class is required with registration

This deposit will be credited towards tuition.

 The remaining tuition is due prior to the start of the camp/class

After August 16th, please include a registration fee of $50 with your deposit.

 

 

Student/Client Name:

Parent's Name:

Mailing Address:

Email Address:

Home Phone:

   Cell phone:

Age of Client:

   Entering Grade:    School District: 

Please choose sessions/time:

 

 

 

 

 

 

 

 

Screening:

 

Please choose your preferred location:

 

  First Choice

 

 

 

 Second Choice

 

 

 

 Third Choice

 

 

 

 Definitely Cannot Attend:

 

 

 

My child has not been through a screening before

 My child is available for screening (days/times):

 

 

 

 

 

Deposit Being Paid by:

  
 

 

 

Click Here to Pay Now

 

Once you have paid, you will return here to submit your form.

 

 

          

 

If you need to register via U.S. Mail, please print this registration form and send it with your payment to:

       FOCUS Initiative

       12919 SW Frwy, Suite 190

       Stafford, TX  77477

 

Thank you for registering with FOCUS Initiative!  Once your deposit is received, your enrollment will be confirmed via the email address provided above.  For further questions regarding Summer registration, please call FOCUS at 281-240-0663.   

 

 

Students will not be placed in a group until

a deposit is received.  Thank you!

                     

12919 Southwest Frwy, Suite 190, Stafford, TX  77477

281.240.0663 phone 281.240.9133 fax