Client Contract • Bright Futures Consulting, LLC

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Client Contract

Click Here to Read: Service Agreement for Bright Futures

Service Agreement Acknowledgement*
- By checking this box I agree to the terms listed in the service agreement.
Student/Client Name:*
Student/Client Email*

(May not be the same as guardian email)
Student/Client Phone Number*
High School
Graduation Year
Birthdate*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Guardian Name
Guardian Phone Number
Guardian Email Address:
(May not be the same as student/client email)
Guardian Name (Optional for Additional Guardian)
Guardian Phone Number
Guardian Email Address:

(May not be the same as student/client email)
Please Select Service/Package:*
- All-Inclusive ($6000)
- Essentials ($4500)
- Birkman Assessment ($800)
- Senior Rush ($4500)
- Career/College Consulting: 1-Hour (Rates vary)
- Career/College Consulting: 3-Hour Package ($549)
- Customized College List ($1200)
- 8th & 9th Grade Package: $1000
- Financial Consulting (Rates vary)
- Essay Workshop ($699)
- Application Workshop ($449)
Hidden
Please Select your Package:*
- All Inclusive Package
- Essentials Package
- Birkman Assessment
- High School Transition Package (8th & 9th)
- Senior Rush Package
- College Transfer Package
- Services Purchased Separately (Drop Down Will Appear)
- Essay Workshop ($699)
- Application Workshop ($449)
Preferred primary consultant*
- No Preference
- Jigisha Doshi
- Dr. Beth Dennard
Payment Preference*
Our central office will contact you within 1-2 business days to complete payment. Please review our payment policy in the Services Agreement.
- I prefer to pay by credit/debit card (I acknowledge this will incur a 3% fee)
- I prefer to pay via bank transfer which has no additional fee
Payment Schedule*
Please review our payment policy in the Services Agreement.
- Enrolling in All-Inclusive Package: prefer to pay half now, then quarterly payments thereafter. The last payment will be October of senior year.
- Enrolling in Essentials Package: prefer to pay half now, then quarterly payments thereafter. The last payment will be July of senior year.
- Enrolling in All-Inclusive or Essentials Package and prefer to pay in full now. ($100 discount will be applied)
- Enrolling in another service and will pay in full
Enroll in autopay*
- I am enrolling in a payment plan and prefer to auto draft my payment method on file.
Bright Futures Consulting agrees to keep all personal, academic, medical and financial information concerning the client or client’s family confidential except in those cases in which the client’s or other’s welfare is at risk and/or the client’s parents/ guardians approve release of client data.
Appointment Policy*
By checking this box, I agree to the appointment policy.
- Clients cancelling or missing an appointment without 24 hours advanced notification will result in an additional $75 charge to the client. Frequently missed appointments may be considered a breach of contract.
Student Information: Does your student identify with any of these categories?*
- Diagnosed Learning Difference(s)
- Receives Special Accomodations at School
- Gifted/Talented
- Other Special Need
- N/A
Special Circumstances: Is there is any specific information that we should consider while working with your student. Examples: Recent loss or transition, change in family or living dyanmics, special interests or talents, mental health diagnosis, disciplinary actions, etc.
Referral Source*
Please indicate how you heard about Bright Futures.
- Referral
- Bright Futures Team Member
- Presentation/Workshop
- Bright Futures Media (Newsletter, Social Media, Etc)
- Internet Search
- Other
If referral, please share their name or organization, so we can thank them.
I grant permission for consultant to speak to college admissions representatives on behalf of my student.
- Yes, I grant permission
I grant permission for my photo to be used for marketing Bright Futures Consulting
- Yes, I grant permission
Student’s signature*
First Last
Guardian’s signature*
First Last
Agreed to and signed this (date):
MM slash DD slash YYYY
Hidden
Select one or more a la carte service as needed (each service must be paid in full):
- (3) Hour Block for Educational Advising: $549
- College/Educational Hourly Consulting: Varies by consultant.
- College Selection: $2,000 (up to 5 consultations) Birkman Assessment Recommended
- Summer Essay Boot Camp: $699 per camp session
- Summer College Application Camp: $449 per camp session
- Financial Planning Hourly Consulting: $175 per hour

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We Have a Clear Lake Location and Satellite Offices in West U, Sugar Land, Memorial, Heights, and The Woodlands.

1322 Space Park Dr, Suite C232 Houston, TX 77058

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