Introduction to College Academics - Registration

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Please note that the Wednesday section is full and students will now be registered for the class period held on Tuesdays, 6:30-7:45 p.m. Eastern. To register for the Introduction to College Writing, please complete and submit the form below:

Student Information

Student Name*

First Middle Last

Student's Personal Email*

Student's Date of Birth*

Cell Phone*

Alternate Phone

Address*

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

Course Selection

I would like to enroll in:*

Class 1 Selection:*

Class 2 of 2 Selection:*

Class 2 of 3 Selection:*

Class 2 of 2 Selection:*

Class 2 of 3 Selection:*

Class 2 of 2 Selection:*

Class 2 of 3 Selection:*

Class 3 Selection:*

Parent/Guardian Information

Relationship to student*

Father

Mother

Legal Guardian

Other

Name*

First Middle Last

Address*

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

Email Address*

Alternate Email

Primary Phone*

Alternate Phone

Educational Information & Background

High School Name*

High School Address*

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

Graduation Year*

College Counselor's Name*

College Counselor's Email*

College Intentions

Please select the option that applies to you:*

I am enrolling at Beacon College, and have already submitted my enrollment deposit.

I have applied to Beacon College.

I have not yet applied to Beacon College, but I intend to.

I do not intend to apply to Beacon College.

Program Payment

1 Course

Price:

2 Courses

Price:

3 Courses

Price:

Total

Credit Card*

American Express

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MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Billing Address*

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

Email for Payment Receipt*

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Phone

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Introduction to College Academics – Registration

Student Information

Course Selection

Parent/Guardian Information

Educational Information & Background

College Intentions

Program Payment

Next Steps

Campus Portals

About Beacon College