Parents First Name:
Parents Last Name:
Parents Email:
Phone:
Mobile:
Address:
City:
State:
Zip Code:
Prior School Name & Phone: Official copies of transcript will be requested.
Payment Method: -None- MasterCard Visa American Express Discover Personal Check
Card Number:
Card Expiration: [mm/dd/yyyy]
Card Security Code:
Billing Address (if different):
Program Enrolling Into: -None- 9th Grade - $1,195.00 10th Grade - $1,295.00 11th Grade - $1,395.00 12th Grade - $1,495.00 Individual Courses - $225.00
Tuition Promotion Code:
Courses: Type the courses you want to enroll in or view the course catalog or planner to determine courses.
Student Name:
Student Email:
Comments: Please provide any detailed instructions or comments you wish us to know.