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Parent Name *
Parent Name
Student Name *
Student Name
Parent Phone Number *
Parent Phone Number
Student Grade Level *
Term *
Class Selection *
Scheduled Absences
Scheduled Absences
In order to qualify for a prorated tuition, please list the dates you expect to miss class (please note, attendance on the first day of a term is mandatory):
If a friend or family member referred you, please input their name in the box below to help us thank them!
Agreement *