Enrollment Form






Please print and mail or fax 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
(Homeschool): 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 Accelerated Program? If so, please check the box.
Accelerated High School Program       

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


Father's Name:                          
Address:                                   
An email from either parent is required to receive assignment schedules, progress reports,...etc.
Email: (Required)                      
Home Phone: (Area Code):       
Employer                                  
Business Phone (Area Code):   

Mother's Name                         
Address:                                   
An email from either parent is required to receive assignment schedules, progress reports,...etc.
Email: (Required)                       
Home Phone (Area Code):        
Employer:                                  
Business Phone (Area Code)    


Brothers/Sisters:       1 2 3 4 5
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______________


YEARLY FEES:
All textbooks, workbooks, and course outlines are supplied.

High School Students (9-12):   $1005.00 per year. ($330.00 downpayment at time of enrollment, 9 monthly payments of $75.00 thereafter).

Accelerated High School Program:  $1300.00 per year. ($380.00 downpayment at time of enrollment, 9 monthly payments of $95.00 thereafter).


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

 I will pay by Money Order          I will pay by Check



MC  Visa  Discover #    Expiration Date:    Amount $

Name on Card :   Signature :   Date:


*A 5% processing fee is added to all credit card payments


Mail to: Malibu Cove High School, Post Office Box 1014 Thousand Oaks, California USA 91358
Fax to: (818) 224-7133


ENROLLMENT FORMS CONTINUED(click here)