Part Time Untapped Learning Sign Up From

We are excited to work with your student in the next academic year! Complete this form to secure your student's spot in the program. Scheduling links will be emailed to enrollees mid to late July.

Student Information

Student Name(Required)
MM slash DD slash YYYY
Enrollment Status(Required)
Is your student on, or will they be on, academic probation?(Required)
Does your student have any siblings currently enrolled in an Untapped Learning program?(Required)
Does your student have any of the following diagnoses?

Parent/Legal Guardian Information

Parent/Legal Guardian Name(Required)
Second Parent/Legal Guardian Name
Mailing Address(Required)
Billing Address
Billing Contact Name(Required)
Billing Address(Required)

Program Information

Review Pricing & Program Options

Select monthly payments or to pay up-front and in full. Up-front and in-full payments are non-refundable.
Pay with a credit card or online bank authorization (direct debit). Credit cards incur a 2.9% convenience fee.

Program Policies Agreement

Program Policies Agreement(Required)

Enrollment Summary

Academic Year (Monthly): $425.25
Early Bird Discount: -$17.50
Total Due Today: $407.75*
Next Bill Due: September 9, 2026
*Credit card payments will incur a 2.9% processing fee.

First payment confirms enrollment. Coaching begins 8/9/26. Monthly billing resumes 9/9/26.

Enrollment Summary

Academic Year (Monthly): $501.67
Early Bird Discount: -$19.44
Total Due Today: $482.22*
Next Bill Due: September 16, 2026
*Credit card payments will incur a 2.9% processing fee.

First payment confirms enrollment. Coaching begins 8/16/26. Monthly billing resumes 9/16/26.

Enrollment Summary

Academic Year (Pay in Full): $4,252.50
Early Bird Discount: -$350
Total Due Today: $3,902.50*
Next Bill Due: N/A (Paid in Full)
*Credit card payments will incur a 2.9% processing fee.

One-time payment confirms enrollment for the full year. This plan is non-refundable.

Coaching begins 8/16/26.

Enrollment Summary

Academic Year (Pay in Full): $4,515
Early Bird Discount: -$350
Total Due Today: $4,165*
Next Bill Due: N/A (Paid in Full)
*Credit card payments will incur a 2.9% processing fee.

One-time payment confirms enrollment for the full year. This plan is non-refundable.

Coaching begins 8/16/26.

Enrollment Summary

Continuous Coaching: $408.33
Early Bird Discount: -$14.00
Total Due Today: $394.33*
Next Bill Due: August 13, 2026*
*Credit card payments will incur a 2.9% processing fee.

First month processed today to secure enrollment in the continuous program.

Continuous coaching must begin by July 13, 2026 to continue to receive the early enrollment discount. The next billing date will be adjusted to reflect your start date accurately.

Discount valid for 12 months. After that, continuous coaching will renew at the regular price.

Enrollment Summary

Continuous Coaching: $469
Early Bird Discount: -$14.00
Total Due Today: $455*
Next Bill Due: August 13, 2026*
*Credit card payments will incur a 2.9% processing fee.

First month processed today to secure enrollment in the continuous program.

Continuous coaching must begin by July 13, 2026 to continue to receive the early enrollment discount. The next billing date will be adjusted to reflect your start date accurately.

Discount valid for 12 months. After that, continuous coaching will renew at the regular price.

Once submitted, your payment method on file will be billed according to your plan selections. It may take a few business days for your plan to process. If you have any questions, please reach out to billing@untappedlearning.com.

Once submitted, you will receive a link to add a payment method to your Chargebee account. If you have any questions, please reach out to billing@untappedlearning.com.