Registration

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Please note this is just a pre-registration. No enrollments or payments will happen until you call us. WHEN INPUTING YOUR FORM OF PAYMENT PLEASE BE AWAE OF THE FOLLOWING. (1) Visa, MC, and Discover will be assessed a 2.59% surcharge on payment amounts. (2) E-check bank draft are FREE of any surcharges. (3) E-check bank drafts will appear on your statement as "JACKRABBIT TECHNOLOGIES". (4) We do not accept AMEX or debit cards of any kind including debit cards that can process as a credit card.

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Referral Information
Family Information
Where do you live?
Additional Info
Contact #1
How Can We Contact You?
Portal Access (your email is your login)
(Emails are kept confidential)
Contact #2
How can we contact you?
(Emails are kept confidential)
Student #1
Additional Info
Required Policies
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Questions or Concerns
Payment Information
Please fill out ONE of the following Payment Methods
eCheck/Bank Draft
(Your name on your bank statement)
(9-digit number)