EmailMe Form - REGISTRATION for APRIL 2016 CSE REVIEW

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
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.
REVIEW PROGRAMS *
Payment Terms *
FULL PAYMENT
INSTALLMENT (P2,000.00 DEPOSIT)
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).
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.