Registration & Payment - Independent Day & Boarding School Services

Student Information

Student Name*

First Middle Last Suffix

Student Nickname

Current Grade*

Year of High School Graduation*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Student Cell Phone

Student Email*

Enter Email Confirm Email

Citizenship (if not U.S.)

Religious Preference

Skype Name

Current School*

Previous School(s) Attended - Please list dates and grades of attendance (if applicable).

Please upload your most recent Unofficial Transcript or Report Card(s) (PDF).

Drop files here or

If you do not upload your transcript or report card(s) with this registration, please bring a hard copy with you to your first meeting.

Current GPA

Secondary School Admission Test (SSAT)

Username	Password

Independent School Entrance Exam (ISEE)

Username	Password

High School Placement Test (HSPT)

Username	Password

CollegeBoard (SAT)

Username	Password

ACT

Username	Password

Naviance

Username	Password

Common Application

Username	Password

Parent/Guardian 1 Information

Parent 1 Name*

First Middle Last Suffix

Parent 1 Email*

Enter Email Confirm Email

Parent 1 Address (if different from Student)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent 1 Cell Phone*

Parent 1 Citizenship (if not U.S.)

Parent 1 High School

Parent 1 Undergraduate Education

College	Degree(s) Earned

Parent 1 Graduate Education

Graduate School	Degree(s) Earned

Parent 1 Occupation

Job Title	Employer

Referred by*

Name of Referral

First Last

Please specify*

Parent/Guardian 2 Information

Parent/Guardian 2

Yes
No

Parent 2 Name

First Middle Last Suffix

Parent 2 Email

Enter Email Confirm Email

Parent 2 Address (if different from Student)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent 2 Cell Phone

Parent 2 Citizenship (if not U.S.)

Parent 2 High School

Parent 2 Undergraduate Education

College	Degree(s) Earned

Parent 2 Graduate Education

Graduate School	Degree(s) Earned

Parent 2 Occupation

Job Title	Employer

Sibling Information

Sibling(s)

Yes
No

Sibling Information

Name	Age	School

Service Option(s)

1. Independent Day & Boarding School Search Service	$2,000
2. Independent Day & Boarding School Application Service	$2,000
3. Independent Day & Boarding School Search Service - Student-Athlete	$2,500
4. Independent Day & Boarding School Application Service - Student-Athlete	$2,500
5. Athletic Profile	$500

NOTE: Paying in two or three installments is available for Service Options 1 - 4 only.

Payment Details

Select Payment Method*

Pay in Full (check)
Pay in Full (credit card)
Pay in Installments

Service

Service Option(s)

Independent Day & Boarding School Search Service
Independent Day & Boarding School Application Service
Independent Day & Boarding School Search Service - Student-Athlete
Independent Day & Boarding School Application Service - Student-Athlete
Athletic Profile

Initial Deposit (Payment Plan)

Independent Day & Boarding School Search Service
Independent Day & Boarding School Application Service
Independent Day & Boarding School Search Service - Student-Athlete
Independent Day & Boarding School Application Service - Student-Athlete
Athletic Profile

Total

$0.00

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Please make check payable in full to "One-on-One College Consulting" and mail to:

One-on-One College Consulting, LLC
Lakeside Office Park
607 North Avenue, Door #14, 2nd Floor
Wakefield, MA 01880

NOTE: Appointment(s) will not be scheduled until payment is received.

If you are not registering for the Independent Day & Boarding School Application Service at this time, would you like us to hold a spot for you? We limit the number of students we work with during the application service, and if you intend to sign up for it in the future, please let us know below:

Application Service - Future Intention*

Yes
No
Not Sure

Parent/Guardian Signature

I confirm that all information provided on this registration form is accurate. I authorize One-on-One College Consulting to charge my credit card for future payment plan installments (if applicable).

Parent/Guardian Electronic Signature*

Next Steps

Once you click on the submit button below, and we have received your payment, you can expect a 'Welcome' email with instructions on getting started with One-on-One College Consulting.

Thank you!

Name

This field is for validation purposes and should be left unchanged.

One-on-One College Consulting

Registration & Payment – Independent Day & Boarding School Services

Student Information

Parent/Guardian 1 Information

Parent/Guardian 2 Information

Sibling Information

Service Option(s)

Payment Details

Parent/Guardian Signature

Next Steps

IECA Associate Member

Nationally available via Skype

MBTI® Certified Practitioner