camp registration form

Please PRINT, FILL OUT and SUBMIT - BS/MD APPLICATION BOOT CAMP REGISTRATION FORM


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 2022?:


II. BS/MD Application Boot Camps 2022 you will be attending:

Session:                                                                                                    Date:

Cost for BS/MD Application Boot Camp:  $10,000
Amount due on or before July 1, 2022:  $10,000 (Non-Refundable)


III. Agreement of Registrant:

I have read and understand information presented about BS/MD Application Boot Camp 2022, this registration form and refund policies.

I understand that the BS/MD Application Camp 2022 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 2022, please mail or wire deposit and mail Registration Form to: Pinnacle Educational Center, 245 Amity Rd, Ste. 203, Woodbridge, CT 06525 or email to: info@bsmdapplicationbootcam.com

AMOUNT DUE: Make Bank Check in the amount of $10,000 per Ivy League Application Boot Camp 2022 payable to: Pinnacle Educational Center, LLC. Please note on check the registered session. Please note that this is non-refundable

REFUND POLICY:  No refund.

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