Schedule Star in the Classroom Signup! CALL US 800-822-9433

SSCR - Schedule Star in the Classroom!

Student Registration Form

*First Name:
*Last Name:
*Email:

*Street Address:
*City:
*State:
*Zip:

*Phone:

*Mock High School Name: (example: J. Smith High School)
*Password:
*Confirm Password:
*Mother's Maiden Name:

*University/College:
*Advising Professor/Instructor’s Name:
*Course#:
*Course Title:
*Enrollment Term:
*Number of Students enrolled:
	* required



Payment Information: (Cost $75)
*Card Holder Name
*Card Type
*Card Number
*Expiration Date	/
*CCV Code	This is the 3 digit number that appears on the reverse side of your credit card (where your signature appears). Amex cards only - the 4 digit number on the front of your card.