Application for (circle one):
GRE
GMAT
LSAT
Name: __________________________________________________________________________
Billing Address: ___________________________________________________________________
City: ____________________________
State: _________
Zip Code ______________
Contact phone: ___________________________ Email:___________________________________
Cost:
**Advanced
Regular
GRE
$799.00
$899.00
GMAT
$899.00
$999.00
LSAT
$899.00
$999.00
** Advanced registration 15 business days prior to class start date
Location (circle one):
UH Main Campus(Saturdays) UH Cinco Ranch(Weeknights)
Registration for class # ______________________ (find class number online) Start date: _____________
Credit card(Circle one):
Visa
Mastercard
American Express
Name on the card: ____________________________________________________________________
Card number: ___________________________________________ Amount to charge: $____________
Expiration date: ____________________________ CCV(security code): _________________________
Signature: ___________________________________________________________________________
Fax application to: 713‐743‐1206 or mail to:
UH Continuing Education – Test Preparation
102 C.N. Hilton Hotel & College
Houston, Texas 77204‐3027
For more information call 713‐743‐1060 or email
msclarke@uh.edu