Student Registration Math Circle 2022-2023 SignupMath Circle 2022-2023$100.00Student RegistrationWe will begin offering the Math circle at two different times this year. Please choose the time that best corresponds to your demographics. Based on space availability and eligibility, we will review your application and place you in the appropriate class. We also charge a $100 registration fee, which is collected annually. Note: Fee is waived for low income families. Please contact info@cskmathcircle.org to get a fee waiver *First Name * First NameFirst Name can not be left blank.Please enter valid data.This first name is invalid. Please enter a valid first name.*Last Name * Last NameLast Name can not be left blank.Please enter valid data.This last name is invalid. Please enter a valid last name.*Email Address * Email AddressEmail Address can not be left blank.Please enter valid email address.Please enter valid email address.This email is already registered, please choose another one.This is the email that will be used to added to google classroom. Do not use your school email address.*Password * PasswordPassword can not be left blank.Please enter valid data.Please enter at least 6 characters.Strength: Very Weak*School's name * School's nameSchool's name can not be left blank.Please enter valid data.*Grade * GradeSelect Grade12345678Please select gradePlease enter valid data.Parent / Gaurdian Information *First Name * First NameParent's first name can not be left blank.Please enter valid data.Please enter valid data.*Last Name * Last NameParen't last name can not be left blank.Please enter valid data.Please enter valid data.*Email * EmailParent's email can not be left blank.Please enter valid data.*Phone Number * Phone NumberPhone Number can not be left blank.Please enter valid data.Please enter valid data.*City * CityCity can not be left blank.Please enter valid data.*State * StateState can not be left blank.Please enter valid data.*Session EnrollingMath Circle - West Coast Chapter - 2 PM PSTMath Circle - East Coast Chapter - 1 PM ESTPlease select the session you wish to enrollPlease enter valid data.By submitting this form you confirm that you have read and understood our Privacy PolicyPlease confirm that you have read and understood our Privacy policyPlease enter valid data.By printing my name in the box and pressing the submit button, I acknowledge that I have read and am electronically signing the CSK Math Circle Rules and Expectations on behalf of myself or my dependent minor participant. Signature SignatureSignature cannot be left blank.Please enter valid data.cropSkip(Use Cropper to set image and use mouse scroller for zoom image.) Select Your Payment GatewayPaypalHow you want to pay? Auto Debit Payment Manual PaymentPayment SummaryYour currently selected plan : , Plan Amount : Coupon Discount Amount : , Final Payable Amount: Submit