JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Connect Learning Fall Registration 21/22
9729 Montgomery Rd Cincinnati, OH 45242
www.connectlearningllc.com
Questions? (513) 426-6514
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Name and Age
*
Your answer
Parent Name
*
Your answer
Parent Phone
*
Your answer
Which service are you interested in?
*
Full Day 1 day per week
Full Day 2 days per week
Full Day 3 days per week
Remote support 1 day per week
Remote support 2 days per week
Remote support 3 days per week
Tutoring
Required
Reserve my spot:
*
Pay registration to hold my spot (choose this option for Full Day or Remote Support) - $50
I would like to schedule a tour or consultation for tutoring - $0
Other:
Special concerns or information about your child:
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
