*Malibu Cove High School is a division of SeaScape Educational Center


Enrollment Form
Please print and mail along with your down payment:




First Name Last MI Gender: M/F
Address     
City           State Zip
Country     
Phone:  Area Code  

Has the student attended school before?  Y/N   

If yes, what grades?
(Public) : K 1 2 3 4 5 6 7 8 9 10 11 12
(Private): K 1 2 3 4 5 6 7 8 9 10 11 12

Student's Birth Date (mm/dd/yy):

Current grade level:                     
Malibu Cove entering grade:       
Is the student enrolling in the Accelerated program?  If so, please mark the appropriate box.
Accelerated high school Program


Malibu Cove beginning month:
Last School Attended:             
Last School Address:              


Father's Name
Address          
Email:             
Father's Home Phone:   (Area Code):
Father's Employer:                              
Father's Business Phone (Area Code):

Mother's Name  
Address             
Email:                
Mother's Home Phone      (Area Code):
Mother's Employer                                
Mother's Business Phone (Area Code):  


Brothers/Sisters: 1 2 3 4
Does the student have a health problem? (Y/N)
If yes, please specify:   

Who will be the teacher?
Highest level of education achieved:     

If my application for enrollment in Malibu Cove Private School is accepted, I will comply with all requirements regarding reports, fees, and instruction. I understand that failure to do so will result in the cancellation of enrollment and loss of credits.

PARENT SIGNATURE_______________________________________________DATE______________


All textbooks, workbooks, and course outlines are supplied.

YEARLY FEES:
High School Students: (9-12)
$ 1005.00 per year
$330.00 down payment due at time of enrollment
Nine monthly payments of $75.00 each month thereafter.

Accelerated High School Program:
($1300.00)
$380.00 down payment at time of enrollment
Nine monthly payments of $95.00 thereafter.


Check ONE of the following methods of payment:
(Please make checks payable to: (SEASCAPE EDUCATIONAL CENTER)

 I will pay by Money Order          I will pay by Check



*A 5% processing fee will be added to all credit card orders

MC  Visa  Discover #    Expiration Date:    Amount $

Name on Card :   Signature :   Date:


Mail to:
SeaScape Educational Center
Post Office Box 1014
Thousand Oaks, California USA 91358
  
( Enrollment Forms Continued below)


Enrollment Forms (Continued)
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