Registration Form for the One Stop College Shop

Session:	South Bay I South Bay II
Student's Name:
Street Address:
City:
State:		Zip:
Phone Number:
Cell Phone Number:
Email Address:
Fax Number:
High School:
Parents' / Parent's Name :
Fill out below if parents' information is different from student's information
Street Address:
City:
State:		Zip:
Parents' Phone Number:
Parents' Cell Phone Number:
How did you hear about us?

Please print this out and mail with your deposit check made out to "The One Stop College Shop" to:

The One Stop College Shop
1600 Rosecrans Avenue
Media Building - 4th Floor
Manhattan Beach, CA  90277

Questions? Call us at (310) 321-7833 or send an email to karen@currericollegecounseling.com