Meridian Enrollment

Please complete the enrollment form below. Once enrolled, we will contact you to confirm your enrollment.

Parent Name*
First Last
Parent Email*
Parent Phone*
Student Name*
First Last
Student Email

Student email is required to create student account in the coding platform. Student will only receive occasional class related emails. Parents will be copied on all emails sent to students.
Student Gender*
Student Grade*
Select Time Slot*
Select Time Slot*
Credit Card

Card Details

Cardholder Name
Product Name*
Price: $149.00
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