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Course Enrollment Form

Complete the form below to enroll your child.

Click here for SPEECH/DEBATE session information.
Click here for MATH session information.

Parent/Guardian First and Last Name *

Parent/Guardian Email *

Parent/Guardian Phone Number *

Student 1 First and Last Name *

Student 1 Email *

Parent/Guardian 2 First and Last Name (if applicable, For PF Only)This is an optional field. If you are planning to bring a partner on for Public Forum, please enter a parent/guardian name for student 2.

Parent/Guardian 2 Email (if applicable, For PF Only)This is an optional field. If you are planning to bring a partner on for Public Forum, please enter a parent/guardian email for student 2.

Student 2 First and Last Name (if applicable, For PF Only)This is an optional field. If you are planning to bring a partner on for Public Forum, please enter a name for student 2.

Student 2 Email (if applicable, For PF Only)This is an optional field. If you are planning to bring a partner on for Public Forum, please enter an email for student 2.

Session Information

*Each student registration includes 8 one-hour tutoring sessions*
An email coordinating scheduling will be sent within 24 hours of registration.

Speech/Debate:
– Speech Private Sessions: $420 (1 student)
– LD Private Sessions: $420 (1 student)
– PF Private Sessions: $500 (1-2 students. Only 1 student should fill out the registration form and complete payment. The second student may join for no additional cost.)

Math:
– Academic Private Sessions: $420 (1 student)
– Competitive Private Sessions: $420 (1 student)

Register for Sessions (please check all that apply) *Speech Coaching (1 student)Debate Coaching – LD (1 student)Debate Coaching – PF (1-2 students)Math Coaching – Academic (1 student)Math Coaching – Competition (1 student)

Enter Promo Code (if applicable)Registering with a sibling, registering for multiple classes, or joining as part of a group? Contact us at info@mentisacademy.org to see if you qualify for a custom discount code.

Apply Mentis DiscountPlease check the box to apply your Mentis discount.Apply $40 Mentis Discount

Your Total Tuition

Payment Method Information

Mentis Academy is happy to offer families several payment options to register for our programs. The payment service below is provided by Stripe. Stripe helps connect your preferred checking or savings account to Mentis Academy’s Stripe account. Stripe is a globally recognized, secure, trusted financial technology company. Mentis Academy does not see or retain your bank info. You aren’t giving your account info or access to your bank account, you are simply using Stripe to approve your bank sharing account and routing number to Mentis Academy’s Stripe Account.

Credit / Debit Card *

You will receive an automated confirmation email instantly after submitting this form and a personalized email from Mentis Academy with class information within 1–2 business days of submitting this form. To add an additional course, please submit a new form selecting only the course you’d like to add.

For questions, email info@mentisacademy.org.

By submitting this form, you are confirming that all information provided is accurate.

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