Enrollment

Welcome to your new path towards education and freedom!

Please complete the fields below. If you have any questions, do not hesitate to Contact Us.

Student name(required)

Student DOB (required)

Student phone number(required)

Student email address(required)

Student address(required)

If first time enrolling, please indicate if student is currently home-schooled or the name of Middle/High School/College/University student is or - in the case of a first-year college student - will be attending. (If not attending, leave blank)

Please choose the option the student would like to sign up for (leave blank if unsure or if your option is not listed)

Parent(s) or guardian(s) name(s) (please list all)

Parent(s) or guardian(s) phone number

Parent(s) or guardian(s) email address

Parent(s) or guardian(s) address (if different from student)

Name and contact information of person to contact regarding payment(required)

Please share any additional information that would be helpful, including goals, strengths, dreams, fears, and interests

How did you hear about us? (If first time enrolling)

Name of person that completed this enrollment (if first time enrolling)

Additional thoughts, comments, and/or suggestions please include here!

Enrollment

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Enrollment

Thank you for enrolling with us – We will be in touch soon to hear how we can best support your needs!

Thank you for enrolling with us – We will be in touch soon to hear how we can best support your needs!

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