Senior Crush Test | Strategies For College

New Client Registration:Senior Crush Advisory Package

Family Information

Parent or Guardian 1

List parent with primary custody of student. If joint custody, please list primary point of contact.

Parent/Guardian 1 Relationship to Student(Required)

Parent/Guardian 1 Name(Required)

First Last

Parent/Guardian 1 Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Parent/Guardian 1 Email(Required)

Parent/Guardian 1 Phone(Required)

Parent or Guardian 2

List parent with secondary custody of student. If joint custody, please list secondary point of contact.

Parent/Guardian 2 Relationship to Student

Parent/Guardian 2 Name

First Last

Parent/Guardian 2 Email

Parent/Guardian 2 Phone

Is address for Parent/Guardian 2 the same as Parent/Guardian 1?

Yes

Parent/Guardian 2 Address

Street Address City State / Province / Region ZIP / Postal Code

Student Information

Student Name

First Last

High School Currently Attending

Graduation Year

Student Email

Student Mobile Phone

Do Student and Parent/Guardian 1 live at same address?

Yes

Student Address

Street Address City State / Province / Region ZIP / Postal Code Country

By checking this box, you agree that the terms, conditions and scope of services for the Senior Crush Advisory Package have been reviewed and that you want to purchase this service.(Required)

Yes (Confirm)

Today's Date(Required)

Parent Signature(Required)

Phone

This field is for validation purposes and should be left unchanged.