Request to Host Seminar

If you are interested in insuring the financial success of your students and, at the same time, raise additional funds for your school’s budget, then fill out the form below:

* denotes required field
Name of High School:	*
School Telephone Number:	*
E-mail Address:
School Web Site:
School Address:
School City:	*
School State:	*

What’s the approximate size of your senior class?	*
What percentage (%) your of seniors do you think go on to college?
Please select the month(s) your school schedules mailing to both parents/high school seniors: * ctrl + click to select multiple


Contact Person:	*
Contacts E-mail Address:	*
Contacts Telephone:	*
Preferred Month for Event (in order of preference. Please include exact day if you know it):
1) 2) 3)
By signing this document, you are NOT obligating your school. This form is only to express your sincere interest in hosting the seminar and to see if your school qualifies. Once we receive this form, one of our representatives will contact you to confirm a date for your high school.
Electronic Signature (type in your name):	*
Principal (or school representative) Name:	*
Principal (or school representative) Phone:	*

Please review all information carefully before submitting