Hotmath School / Teacher License Application

1. Please print and fill out manually, one form required per school.
Responsible Person
School/college
District (if applicable)
City, State, ZIP
Phone
Email to receive password and usage reports
Please tell us how you heard about Hotmath
Today's Date

2. Solutions: Check either Class-based or Enrollment-based pricing.

Class-based:

__1 Class: $75
__2-5 Classes: $135
__6-10 Classes: $225

Note: A class is up to 35 students.

Enrollment-based:

___ School enrollment of _____ x $.75 = $________ (min = $225)

Note: Count all math students using textbooks covered on Hotmath, except those marked as Free.

___Check here if this is a renewal

New Accounts:

12-month license period will start immediately unless you enter a delayed start date here: __________________

3. Video Lessons for Pre-Algebra, Algebra 1, and Geometry
To order videos, check here __ and add 20% of Solutions fee, for new order total: $________

4. Online math tutoring: Indicate number of each package below

__ 10-hour trial packages @ $199
__ 100-hour packages @ $1,995
__ 1000-hour packages @ $18,995

Total tutoring: $____________

New grand total: $____________

5. Select password (optional)
New accounts: please select a password. Renewing accounts: replace former random-format password with this new one: ______________________.

6. Send this Application with your PO, check, or credit card information to:
Hotmath, Inc.
18 Sunset Drive
Kensington, CA 94707
Tel 510-524-5525 | Fax 510-372-2756
Email: schools@hotmath.com

Credit Card Information:

Credit card type: ___________________________

Card number: _________________________________

Expiration date:___________ Security code: _______