1. { binding displayValue, mode=oneTime }
{ binding firstError.message }
{ binding firstError.message }
You will receive a confirmation email and a copy of your application at this address.

Parent/Guardian Information

Please add legal parents or guardian for your student here. Click on +Add Parent/Guardian to add all parents involved.

Parent/Guardian {binding ItemNumber}

{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
This number can be a mobile or landline.
Will you be the primary contact?
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{# pageNumbers}
Select Country
{ binding firstError.message }
Time Zone
{ binding firstError.message }
Best Time to Call
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{# pageNumbers}

Student Infomation

If you have multiple children to register, click +Student to Enroll.

Student {binding ItemNumber}

{ binding firstError.message }
Gender
{ binding firstError.message }
{ binding firstError.message }
Does your child prefer to go by a nickname?
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Include the grade level that your student is currently in.
{ binding firstError.message }
This will be the next grade level from the grade level that your student is in currently.
Please select the subjects to enroll:
{ binding firstError.message }
{ binding firstError.message }
Program Type
{ binding firstError.message }
Select Payment Type
{ binding firstError.message }
Preferred Payment Plan
{ binding firstError.message }
Select Payment Type
{ binding firstError.message }
Preferred Payment Plan
{ binding firstError.message }
{ binding firstError.message }
Before we place your student, we may need to do a reading assessment. We will be in touch to discuss this further.
Program Type
{ binding firstError.message }
Select Payment Type
{ binding firstError.message }
Preferred Payment Plan
{ binding firstError.message }
{ binding firstError.message }
Before we place your student, we may need to do a math assessment. We will be in touch to discuss this further.
Program Type
{ binding firstError.message }
Select Payment Type
{ binding firstError.message }
Preferred Payment Plan
{ binding firstError.message }
Select Payment Type
{ binding firstError.message }
Preferred Payment Plan
{ binding firstError.message }
{ binding firstError.message }
Program Type
{ binding firstError.message }
Select Payment Type
{ binding firstError.message }
Preferred Payment Plan
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Leave blank if there are no needs.
{ binding firstError.message }
{ binding firstError.message }
{# pageNumbers}
How did you hear about us?
{ binding firstError.message }
{ binding firstError.message }
Leave blank is you do not have a discount code.
{ binding firstError.message }
{ binding firstError.message }
{# pageNumbers}

All invoices for tuition payments are accepted using Google Pay. This option allows us to keep our tuition rates low and not add additional fees for using debit or credit cards. Fees are due before the first day of class. A $25.00 one time non-refundable application fee, per student enrolling is required to be paid with this application. Visa, Mastercard, Discover and American Express are the only forms of payment accepted for the application fee.

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}---
{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}
{# pageNumbers}

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}
Submitter's Name
{binding displayValue}
Submitter's Email Address
{binding displayValue}

Parent/Guardian Information

Please add legal parents or guardian for your student here. Click on +Add Parent/Guardian to add all parents involved.

Parent/Guardian {binding ItemNumber}

Parent/Guardian Name
{binding displayValue}
Date of Birth
{binding displayValue}
Best Contact Number
{binding displayValue}
Will you be the primary contact?
{binding displayValue}
Email Address
{binding displayValue}
Relationship to Student
{binding displayValue}
{ binding firstError.message }
Select Country
{binding displayValue}
Time Zone
{binding displayValue}
Best Time to Call
{binding displayValue}
Address
{binding displayValue}
Address
{binding displayValue}

Student Infomation

If you have multiple children to register, click +Student to Enroll.

Student {binding ItemNumber}

Student's Legal Name
{binding displayValue}
Gender
{binding displayValue}
Student's Date of Birth
{binding displayValue}
Does your child prefer to go by a nickname?
{binding displayValue}
What is the nickname?
{binding displayValue}
Highest Completed Grade
{binding displayValue}
Enrolling Grade
{binding displayValue}
Please select the subjects to enroll:
{binding displayValue}
Grammar
{binding displayValue}
Program Type
{binding displayValue}
Select Payment Type
{binding displayValue}
Preferred Payment Plan
{binding displayValue}
Select Payment Type
{binding displayValue}
Preferred Payment Plan
{binding displayValue}
Literature
{binding displayValue}
Program Type
{binding displayValue}
Select Payment Type
{binding displayValue}
Preferred Payment Plan
{binding displayValue}
Saxon Math
{binding displayValue}
Program Type
{binding displayValue}
Select Payment Type
{binding displayValue}
Preferred Payment Plan
{binding displayValue}
Select Payment Type
{binding displayValue}
Preferred Payment Plan
{binding displayValue}
Spanish
{binding displayValue}
Program Type
{binding displayValue}
Select Payment Type
{binding displayValue}
Preferred Payment Plan
{binding displayValue}
Student's hobbies or interests:
What motivates your child?
Current Type of School
{binding displayValue}
Student Needs
{binding displayValue}
Please provide a brief explanation about this student need.
{ binding firstError.message }
How did you hear about us?
{binding displayValue}
Enter COUPON Code for Special Discount:
{binding displayValue}
Name of who referred you?
{binding displayValue}
E-mail address of the person who referred you
{binding displayValue}

All invoices for tuition payments are accepted using Google Pay. This option allows us to keep our tuition rates low and not add additional fees for using debit or credit cards. Fees are due before the first day of class. A $25.00 one time non-refundable application fee, per student enrolling is required to be paid with this application. Visa, Mastercard, Discover and American Express are the only forms of payment accepted for the application fee.

Cognito Forms{{ Cognito.resources["powered-by-cognito"] }}