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

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



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


MC  Visa  Discover #    Expiration Date:    Amount $

Name on Card :   Signature :   Date:

Mail to:
SeaScape Educational Center / P.O. Box 1014 Thousand Oaks, California USA 91358
  ( Enrollment Forms Continued below)


Enrollment Forms (Continued) Click Here: