EmailMe Form - REGISTRATION for MARCH 2016 BLEPT REVIEW (LIVE)

Name *

First MI Last

School/Course *

Email Address *

Please provide email address so we can send you your personal code to use the system.

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

For mobile use this format 999-999-9999
(Please remove the 0 at the start of the number)

Confirm

### - ### - ####

Birthday *

MM / DD / YYYY

Enter 04/04/1994 for April 4, 1994

REVIEW PACKAGES

Please choose one option.
COMPLETE REVIEW PACKAGES
BEED - General Education + Professional Education + Final Coaching
BSED - same as BEED + Specialization.

REVIEW PROGRAMS *

ONLY COMPLETE PACKAGE Enrollees are
entitled to FREE UNLIMITED
ONLINE ACCESS and PAJAMA REVIEW
SESSION at NO EXTRA CHARGE.

Payment Terms *

FULL PAYMENT

INSTALLMENT

A reservation fee of Two Thousand Pesos (P2000.00) will be required upon enrollment. This amount will be deducted from the total fee to determine balance due on the first day of classes (for FULL PAYMENT with DISCOUNT).

MODE of PAYMENT *

For Bank Deposit and Smart Padala Payments please send to us details of your transactions so they can be reflected in your account immediately.

Where did you learn about TESTSMART? *

We would appreciate to know where you heard about our company. Please type in the name of your friend, your school or any site online.