Marketing Homeschool Request

Thank you for your interest in ALEKS! This offer is for first time ALEKS users only. To receive your complimentary month of ALEKS, please enter your contact information below and then click "Request Free Trial."

Parent First Name:

Parent Last Name:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Parent Email:

Confirm Email:

Which email format do you prefer? (please check one)  ^*
     Rich format (permits images, colors, and fonts)
     Plain text (no images, colors, or fonts)

Help Your Child Achieve with ALEKS!

How did you hear about ALEKS?

Student First Name:

Student Last Name:


	For multiple children, please complete a separate request for each child.

* = Required field.

Refer 2 homeschooling parents with K-12 children and extend your 1-month trial to 2-months.
Note: You cannot refer yourself or a member of your household. Within 2 weeks of submitting this request, ALEKS Corporation will validate the referred email addresses and notify you of the trial extension.

Homeschooling Parent 1:

First:

Last:

Email:

Homeschooling Parent 2:

First:

Last:

Email:


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