LOOKSFAM PILOT RUN FORM School / Institution Name * Authorized Representative Name * Representative Email * Representative Mobile * Program / Department * Estimated No. of Students * Where did you heard LOOKSFAM? * Pilot Duration * Select duration 30 Days 60 Days 90 Days Pilot Run Objectives * Improve board exam passing rate Integrate adaptive review tools for classes Supplement existing review programs Evaluate LOOKSFAM for long-term institutional use Others (please specify): Terms & Conditions * I confirm that the institution is applying for the LOOKSFAM Pilot Run. I acknowledge that approval is subject to Bentamo - BNTM Technologies Inc. verification and availability. I understand that pilot access is for evaluation purposes only. Data Privacy Consent: I consent to the collection and processing of information for evaluating eligibility and conducting the pilot run, in compliance with the Data Privacy Act of 2012 and GDPR (if applicable). Submit Application