New Student

Prior Employee
Franchise Owner,
Franchise Employee
Other Prior Student

YEAR

INCOME TAX COURSE/SEMINAR

ENROLLMENT, ATTENDANCE, AND ACHIEVEMENT RECORD

Name: _________________________________________

Name of course or seminar _______________________________

GRADE
ATTENDANCE RECORD

Address: _______________________________________
_______________________________________
_______________________________________

REVIEWS

SCHEDULED
QUIZZES
AND TESTS

1
2

Phone: Res. ____________ Bus. ___________________

Date Registered:_________________________________

4
5

Class Time: Morning ______ Afternoon ______ Evening ______

Circle Days:

Th

6
7
8
9

Instructor: ______________________________________

10

Class Location: _________________________________

12

11

Date Class Begins: ______________________________

13
14
15

BOOKS & MATERIALS ISSUED:

Date
Items

16
17
18
19
20
21
22
23
24

Course Grade:
Points

Percent

Letter Grade

Percent

Letter Grade

Final Exam Grade:

PAYMENT RECORD:
DATE
AMOUNT PAID

BALANCE DUE

Points

Date course completed and certificate awarded: ______________

COMMENTS: (Strong-weak tax areas, etc.)

INSTRUCTORS EVALUATION OF STUDENT:

Poor
Fair
Good Excellent
Punctuality
Participation

IF COURSE NOT COMPLETED, EXPLAIN:

Comments regarding punctuality and participation:

Instructors Signature: __________________________________

2801-3-01