Brain Train is 2015

BRAIN TRAIN STUDENT INFORMATION SHEET IMPORTANT: MUST BE FILLED OUT COMPLETELY! THIS WILL BE USED IN SECTIONING AND SEATING ARRANGEMENT AND IN ISSUING ANNOUNCEMENTS AND STUDENT ASSESSMENTS. NO BLANKS PLEASE! Name _________________________________________________________ Nickname___________ Height __’___’’ Last Name

First Name

Middle Name

Home Address ____________________________________________________________________________________ Tel. No. Landline _____________ Mobile _______________________ Email __________________________________ Father’s Name _________________________________ Business or Office Address ____________________________ Tel. No. Landline _____________ Mobile _______________________ Email __________________________________ Mother’s Name ________________________________ Business or Office Address _____________________________ Tel. No. Landline _____________ Mobile _______________________ Email __________________________________ School (pls. do not abbreviate) __________________________________________________________ Recent school grades (pls. estimate and do not leave blank) Math _____ Science _____ English _____ Average Grade _____ Class/Batch Rank _____ out of _____ Pilot Section? ☐ yes ☐ no ☐ n/a Academic Awards Received ____________________________________ Does the student have special needs or a handicap? (poor eyesight, ADHD, autism, attitude problems, etc.) ☐    yes ☐    no If yes, what: ________________________________________________ How did you know about BRAIN TRAIN? ___________________________ ---DO NOT FOLD OR SOIL---

ENROLLMENT DETAILS Date: _______________________________ Enrolling for: ☐ High School Entrance Review ☐ UPCAT/College Entrance Review ☐ Summer Enrichment Venue and Schedule: ___________________ Initial payment: _______________________ Signed RCA? ☐ yes ☐ no I have received and understood the contents of the Review Guide and the PLS READ Flier. ____________________ Printed Name

_______________ Signature

BRAIN TRAIN STUDENT INFORMATION SHEET IMPORTANT: MUST BE FILLED OUT COMPLETELY! THIS WILL BE USED IN SECTIONING AND SEATING ARRANGEMENT AND IN ISSUING ANNOUNCEMENTS AND STUDENT ASSESSMENTS. NO BLANKS PLEASE! Name _________________________________________________________ Nickname___________ Height __’___’’ Last Name

First Name

Middle Name

Home Address ____________________________________________________________________________________ Tel. No. Landline _____________ Mobile _______________________ Email __________________________________ Father’s Name _________________________________ Business or Office Address ____________________________ Tel. No. Landline _____________ Mobile _______________________ Email __________________________________ Mother’s Name ________________________________ Business or Office Address _____________________________ Tel. No. Landline _____________ Mobile _______________________ Email __________________________________ School (pls. do not abbreviate) __________________________________________________________ Recent school grades (pls. estimate and do not leave blank) Math _____ Science _____ English _____ Average Grade _____ Class/Batch Rank _____ out of _____ Pilot Section? ☐ yes ☐ no ☐ n/a Academic Awards Received ____________________________________ Does the student have special needs or a handicap? (poor eyesight, ADHD, autism, attitude problems, etc.) ☐    yes ☐    no If yes, what: ________________________________________________ How did you know about BRAIN TRAIN? ___________________________ ---DO NOT FOLD OR SOIL---

 

ENROLLMENT DETAILS Date: _______________________________ Enrolling for: ☐ High School Entrance Review ☐ UPCAT/College Entrance Review ☐ Summer Enrichment Venue and Schedule: ___________________ Initial payment: _______________________ Signed RCA? ☐ yes ☐ no I have received and understood the contents of the Review Guide and the PLS READ Flier. ____________________ Printed Name

_______________ Signature

UPCAT Refresher & Intensive ACET/DLSUCET Registration Form

UPCAT Refresher & Intensive ACET/DLSUCET Registration Form

Date: ______________________

Date: ______________________

  Name: ________________________________________________________

Name: ________________________________________________________

School: ________________________________________________________

School: ________________________________________________________

BT Review Venue: ____________ Section:_____ Reviewee No.___________

BT Review Venue: ____________ Section:_____ Reviewee No.___________

Contact Nos.

Contact Nos.

Student: ____________________

Student: ____________________

Father: _____________________

Father: _____________________

Mother: _____________________

Mother: _____________________

Email Address

Email Address

Father: ________________________________________ 

Father: ________________________________________ 

Mother:________________________________________ 

Mother:________________________________________ 

Enrolling for:

Enrolling for:

□ UPCAT Refresher □ Intensive ACET/DLSUCET

Venue: _________________ Date: ____________ Venue: _________________ Date: ____________

‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 

STAPLE THIS TO YOUR REVIEW MANUAL. THIS MUST BE PRESENTED DURING THE REVIEW. DO NOT LOSE THIS!

□ UPCAT Refresher □ Intensive ACET/DLSUCET

Venue: _________________ Date: ____________ Venue: _________________ Date: ____________

‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 

STAPLE THIS TO YOUR REVIEW MANUAL. THIS MUST BE PRESENTED DURING THE REVIEW. DO NOT LOSE THIS!

Date: ______________________

Date: ______________________

This is to certify that ______________________________________________

This is to certify that ______________________________________________

has paid the amount of P___________________ as full payment for _______

has paid the amount of P___________________ as full payment for _______

_________________________________ on ___________________________.

_________________________________ on ___________________________.

_____________________________________________________to be held at

by:

Payment & Student Reg. Form received

_______________________________

_____________________________________________________to be held at

by:

Payment & Student Reg. Form received

_______________________________ Authorized BT Representative 

Authorized BT Representative