6-12 Orientation Course Registration
Legal Name of Student
*
First Name
Last Name
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Country of Birth
*
Nationality (Country of Citizenship)
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
We are required to share your legal name, DOB, nationality, country of birth, and email with AMI in order to register you for the course.
*
Agreed
I give permission for MTCSTL, its subsidiaries, and agents the rights to use photographs/videos of me for future promotional or fundraising materials or events:
Yes
No
How Did You Hear About This Course?
*
Current School Affiliation **If applicable**
Please share any questions or areas of interest that you have regarding this course.
Course Fee
Payment of the $950 Course Fee is required for you to be registered for our program. This fee is nonrefundable.
Payment
*
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6-12 Orientation Course Fee
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950.00
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