EmailMe Form - GROUP REGISTRATION for 2016 BLEPT REVIEW

Lead Contact Name *

First MI Last

School/Course *

Email Address *

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

Phone *

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

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

Confirm

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

REVIEW PACKAGES

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

REVIEW PROGRAMS *

Corresponding discount will be deducted from the Review Fee reflected here. Discounts are applied per person in the group.

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.

Number of Enrollees *

3-5 pax

6-9 pax

10 or more pax

ADDITIONAL DISCOUNTS for GROUPS
P100 OFF (3-5pax)
P200 OFF (6-9pax)
P300 OFF(10pax or more)

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).

Please encode the names of the enrollees in your group with the Review Program they chose. *

Enter ALL the members of the GROUP (including the Lead Contact)
Example:
1. Dela Cruz, Juan (Complete BEED)
2. Santos, Maria (Final Coaching)
3. Mariano, Dante (Complete BSED)
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Total # of Enrollees in Group = 3

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.