Whiz Kid Academy Enrollment Form – Scholar Track

Select your enrollment track:

Select your curriculum enhancements (recommended):

Choose your live class schedule:

Parent First Name:

Parent Last Name:

Child First Name:

Child Last Name:

Child Date of Birth:

Email:

Mailing Street Address

Address Line 2:

City:

State:

Postal / Zip Code

How did you hear about us?

Phone:

Choose Login Password:

Confirm Password