Now Enrolling — September 2026

Company Keepers™ Registration Form

Thank you for your interest in Company Keepers™. Please complete the form below — it takes approximately 3–5 minutes. Once we receive your registration, we'll be in touch with next steps, including payment information and the Parent Intake & Baseline Assessment.

Date *

Program Schedule

Fields marked with * are required.

Tuesdays, 4:00–6:00 PM — Brunswick County

Thursdays, 4:00–6:00 PM — New Hanover County

Program Length: 16 weekly sessions (approximately one school semester)

Tuition: $80 per session — $1,280 total

Payment options and due dates will be provided after registration is received.

I understand Company Keepers™ is a 16-week program. *I understand the tuition is $80 per session ($1,280 total). *

Parent / Guardian Information

Parent / Guardian Name *

Relationship to Participant *

Phone Number *

Email Address *

Preferred Contact Method

CallTextEmail

Participant Information

Participant Name *

Date of Birth *

Age

Grade *

School

Emergency Contact Name

Emergency Contact Phone

If different from parent

Preferred Session Location *

Tuesday

Brunswick County · 4:00–6:00 PM

Thursday

New Hanover County · 4:00–6:00 PM

How did you hear about AIM?

Your information is kept confidential and used only for program placement.