*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
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 Home Phone: (Area Code):
Father's Business Phone (Area Code):
Mother's Home Phone (Area Code):
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.