��

Quantum Instructor Account Request

Thanks for your interest in the Quantum. To request a free instructor account to review our tutoring software, please complete the information below. * Indicates required information.

Registrant Information	�
* First Name
* Last Name
Title
* School/Institution
* Email Address
* Confirm Email Address
Phone

* Courses Taught (check all that apply)	�
�	Accounting
	Principles
	Financial
	College
	Intermediate
	Managerial
Other

�	Chemistry
	General
	Honors
	AP
	College
Other

Other Courses Taught

* Total estimated number of students taking your course each year

* Textbook(s) used

Other Comments/Requests

�How did you hear about us?	Search Engine
�	Email
�	Faculty Member
�	Conference/Event
�	Other

� �
For verification purposes, please enter the code from the above image box here
�	�

Thanks for your interest in Quantum. We will respond to your request within one business day.

	��