camp registration form

*Empowering you to Brainstorm, Tune-up and Polish your BS/MD Applications!*


Please register early. Space is limited! Your space will only be held with a deposit (See below)

I. Student Information

Student's Name:

Parent's Name:

Mailing Address:

Home Phone:                                                                                                              Fax:

Cell Phone:                                                                                                                 E-mail:

Name of High School currently attending:

Current High School Year:                                                                                         Date of Birth:

How did you hear about the Ivy League Application Boot Camp 2018?:

II. BS/MD Application Boot Camps 2020 you will be attending:

Session:                                                                                                    Date:

Cost for BS/MD Application Boot Camp:  $12,000
Non-Refundable Deposit:  $6,000 (Required to reserve your space)
Amount due on or before July 1, 2020:  $6,000 (Non-Refundable)

III. Agreement of Registrant:

I have read and understand information presented about BS/MD Application Boot Camp 2019, this registration form and refund policies.

I understand that the BS/MD Application Camp 2019 is for high school juniors or international students who will be rising seniors or international student (transfers) this summer with interests in the college admissions process to BS/MD programs. I expect to be in attendance (except for unexpected emergencies) for my registered Boot Camp Session.

Attendee/Student Signature:                                                                                             Date:

Parental Signature:                                                                                              Date:

(Please note: If a student is under the age of 18, parental approval [by signature] of participation in a Boot camp session must be given.)

IV. Reservation, Payment, Refund and Discount Policies

RESERVATION: To reserve your place for BS/MD Application Boot Camp 2019, please mail or wire deposit and mail Registration Form to: Pinnacle Educational Center, 245 Amity Rd, Ste. 203, Woodbridge, CT 06525 or email to:

DEPOSIT: Make Check or Money Order in the amount of $6,000 per BS/MD Application Boot Camp 2020, payable to: Pinnacle Educational Center, LLC.  Please note on check the registered session.  Please note that this is a non-refundable deposit.

BALANCE DUE: Make Check or Money Order in the amount of $6,000 per BS/MD Application Boot Camp 2019 payable to: Pinnacle Educational Center, LLC. Please note on check the registered session.

REFUND POLICY:  No refund of deposit and/or balance due.

PAYMENTS BY BANK WIRE:  Please call our office for details.