SeaScape Customizable Curriculum Form


Parent Name:__________________________________                     Student Name:__________________________________

Student Address: ________________________________________

Grade (this year): ______________________________

Date: _________________________________

If you need your child's curriculum customized, please answer the following questions and return this questionnaire to Seascape Educational Center along with your enrollment form. ( Not all subjects may be available at the requested levels.)

1. What levels in each subject do you feel your child would be most comfortable at? (Check all that apply)

GRADE LEVEL
Subject Remedial Below At Current grade 1 Year Above current Advanced Other (Please Specify)
Math
0
0
0
0
0
 ___________________
English
0
0
0
0
0
 ___________________
Science
0
0
0
0
0
 ___________________
Spelling
0
0
0
0
0
 ___________________
Geography
0
0
0
0
0
 ___________________
History
0
0
0
0
0
 ___________________
Health
0
0
0
0
0
 ___________________
Writing
0
0
0
0
0
 ___________________
Penmanship
0
0
0
0
0
 ___________________
Reading (Literature)
0
0
0
0
0
  
Reading (Comprehension
0
0
0
0
0
  
Research & Study Skills
0
0
0
0
0
  



2. Is there a subject not listed that you would like your child to learn? If so, let us know here:

_____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

3. What special interests does your child have?

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

4. What main goal would you like to see your child reach this year?

_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

5. Additional comments:

_______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

6. Please let us know how you heard about Seascape Educational Center:

___*Recommended by a friend    ___The Link Homeschool Paper    ___Other Advertisement

___Internet Search Engine          ___WWW Message Board              ___TV/Radio Advertisement

Name of friend who recommended you to Seascape: __________________________________________________________________


 Enrollment forms continued:
ENROLLMENT AGREEMENT POLICY