Enrollment Form

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border-top:1px solid #393939; clear:both; display:none; width:100%!important; position:relative; z-index:999999!important; height:90px!important"> <div class="adCenterClass" style="display:block!important; overflow:hidden; width:916px;"> <div id="footerAd_container" style="display:block!important; float:left; width:728px"> <iframe id="lycosFooterAdiFrame" style="border:0; display:block; float:left; height:96px; overflow:hidden; padding:0; width:750px"></iframe> </div> </div> </div> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=82 BGCOLOR="#006699" TEXT="#080000"> <div> <B>Enrollment Form</b></div> <div> </div> </td> </tr><tr> <td valign="top" width=165 BGCOLOR="#FFCC66" TEXT="#080000"> <div> <A HREF="index.htm" TARGET="_top" TITLE="Algebra Tutor"><U><B><IMG SRC="02d0e0e0.gif" border=0 width="14" height="14" ALT="up" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></b></U></A><B>      </b><A HREF="id22.htm" TARGET="_top" TITLE="College Prep Math Info"><U><B><IMG SRC="02f0e0e0.gif" border=0 width="14" height="14" ALT="previous" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></b></U></A><B>  </b><A HREF="id6.htm" TARGET="_top" TITLE="Contact Us"><U><B><IMG SRC="0300e0e0.gif" border=0 width="14" height="14" ALT="next" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></b></U></A><B>       </b><IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14"></div> <bR> <div> <A HREF="index.htm" TARGET="_top" TITLE="Algebra Tutor"><U><B>Home</b></U></A></div> <div> <A HREF="id22.htm" TARGET="_top" TITLE="College Prep Math Info"><U><B>College Prep Math Info</b></U></A></div> <bR> <div> <B>On this form you may order:</b></div> <bR> <div> <B>1.  The Algebra Tutor course                    </b></div> <bR> <div> <B>2.  The College Preparatory Math course</b></div> <bR> <bR> <bR> <bR> <bR> <bR> <div> <B>course course  Lessons</b></div> </td> <td valign="top" height=398 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <B><IMG BORDER="0" SRC="Symb075c00b70190ff000000.gif" HEIGHT="27" WIDTH="27" ALIGN="bottom" HSPACE="0" VSPACE="0">Enrollment Form</b></div> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you are interested in learning math beyond that given at this web site you may register for the Stratford School: </b></div> <bR> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">1.  Algebra Tutor Course, or, </b></div> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">2. the College Preparatory Math Course</b></div> <bR> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Use the Enrollment Form below to tell us which program you wish to participate in.</b></div> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f0ff000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">1.  If you are interested in receiving the complete Algebra Tutor program please copy the following paragraph into the COMMENTS window below.</b></div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">To Registrar:  I would like to receive the 10 <I><B>Student Mathematical Reviews</b></I> and videos for the <B>Algebra Tutor </b> program.  Please send me the Review and video of classroom explanations for <B>LESSON 1.  </b> I understand that I will pay $19.95 by charge card, check or money order.  I can receive a FULL REFUND of my money if I am not satisfied and cancel the program at any time.</div> <bR> <bR> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f0ff000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">2.  If you wish to receive the Lessons for the College Preparatory Program please copy the information below into the COMMENTS window.</b></div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">To Registrar:  I would like to receive the 7 <I><B>Student's Helpful Guide to Understanding Mathematics </b></I>and classroom videos for the <B>College Math Preparatory Course</b>.  Please send me the Review and video of classroom explanations for <B>LESSON 1.  </b> I understand that I will pay $65.00 for <B>LESSON 1</b>, by charge card, check or money order.  I can receive a FULL REFUND of my money if I am not satisfied and may cancel the program at any time.  I will receive a certificate upon completion of the course.  This course will include personal tutoring from the Course Instructor by Email and telephone</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Full payment is due in advance. We accept all major credit cards including VISA, MasterCard, American Express, and Discover.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0"> <form action="https://www.paypal.com/cgi-bin/webscr" method="post"> <input type="hidden" name="cmd" value="_xclick"> <input type="hidden" name="business" value="easylearn@mybluelight.com"> <input type="hidden" name="undefined_quantity" value="1"> <input type="hidden" name="item_name" value="Algebra Tutor Learning Program"> <input type="hidden" name="item_number" value="Algebra 101"> <input type="hidden" name="amount" value="19.95"> <input type="hidden" name="return" value="http://algebratutor.tripod.com"> <input type="hidden" name="cancel_return" value="http://algebratutor.tripod.com"> <input type="image" src="https://www.paypal.com/images/x-click-butcc.gif" border="0" name="submit" alt="Make payments with PayPal - it's fast, free and secure!"> </form>  </div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0"> <FONT SIZE="3" COLOR="#000000" FACE="Arial" >If you will be paying by check, please make your check payable to Stratford School and mail your payment to:</FONT></div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Registrar</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Stratford School </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">201 Flagler Ave.</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Edgewater, FL 32132</div> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">HOW TO GET STARTED</b></div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">To answer any questions or to get started, please contact Stratford School by sending us an Email below.  Thanks!</div> <bR> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b7016800000000.gif" HEIGHT="24" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0"> <form action="http://formmail.trellix.com/servlets/TlxMailer" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="FirstName,LastName,Address1,City,State,Zip,Phone,Comments,Email"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Your complete ALGEBRA TUTOR will be shipped within 7-days of receipt of your order. "><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A request form for ALGEBRA TUTOR was submitted"><input type="hidden" name="tlx_EmailTo" value="accounts@easylearn.8m.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 1:<br> <input type="text" name="Address1" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Zip:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td align="left">Comments:<br> <textarea name="Comments" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> <bR> <div> <A HREF="id6.htm" TARGET="_top" TITLE="Contact Us"><U><IMG BORDER="0" SRC="Symb075c00b7011800990000.gif" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Contact Us!</U></A></div> </td> </tr></table></body>