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Boston Academy - Student Enollment Form

Student's Name *
Student's Email ID *
Student Current Grade *
Class Enrolled *
Cell Phone
Student's home address *
Home Phone *
Parent's home address (if different from above)
Does the student have any allergies/special needs?
Emergency contact information during tutoring time *
Additional Information
Parent's Name *
Security Code *
Note: Payment can be made by check payable to Boston Academy
145 Bullard St.
Sharon, MA 02067
Or pay using PayPal