Step Two: Registration Form

Register today for 2020-2021! The $125 family registration fee is due with your registration form below. The family registration fee is separate from the first tuition payment that is typically due before student work begins. An option to register additional students is available on the next screen. Additional students require much less information. 

Need Help? Please call 276-496-7777 ext. 221 8am-4:30pm EST if you need any assistance OR use our Ask A Live Question when available!

STUDENT INFORMATION:

Full Legal Name (required)

Date of Birth (required)

Male or Female (required)

Student Grade Level 2020-2021 year (required)

Last School Attended (required)

School's City (required)

School's State (required)

Select the program/curriculum structure for your student, if known:

10 Month Traditional Year or 12 Month Year Round Option (required)
For Kindergarten or Pre-Kindergarten, choose Traditional.

PARENT INFORMATION:

Parent Name or Names (required)

Mailing Address (required)

Street Address

City (required)

State (required)

Zip (required)

County (required)

Person Responsible For Tuition (required)

Select how you will be paying the $125 Family Registration Fee. If you will call in your payment information to pay the registration fee, please enter the day and time you will call in your payment information.

If calling in your payment information, when will you call?
Our telephone payment hours are 8am-4pm EST, 7am-3pm CST, 6am-2pm MST, 5am-1pm PST.

Day you will call? (for call in payment)

Approximate time you will call? (for call in payment)

Email- primary not junk account (required)

Home Telephone (required)

Cell Phone

SIGNATURE:

How Did You Find Us

Do you have a referral code?

By entering my name in the Signature box(es), I understand and agree with the above statements and also verify the information entered is correct.

Parent Signature (required)

Signature Date (required)

The next screen will ask if you want to register another additional student OR if you are finished. If you are finished, you will go to a confirmation screen where you can either pay the family registration fee or view information on how to call in your payment information. Thank you!

If error message when submitting, look for any uncompleted questions above and resubmit again.