0 JO Registration Form old form

Juku Online Classes Registration Form. One registration is required per family.

First

Last

This form can also be used for later registration additions or comments.

Email *

First

Last

Email and Phone number are required.

Student 1 *

First

Middle

Last

(1) First child's name (first and last name); current grade (if summer, use Sept. grade), and; all courses of interest.

Student 2

First

Middle

Last

(2) Second child's name (first and last name); current grade (if summer, use Sept. grade), and; all courses of interest.

Student 3

First

Middle

Last

(3) Third child's name (first and last name); current grade (if summer, use Sept. grade), and; all courses of interest.

Comments and Referrals:

Add any course, payment, or registration comments, or any referral information.