Enrollment Deposit

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A credit card can be used to pay the deposit using this form and will be applied toward your tuition payments. Please sign the student contract, which was mailed to you, and return it to the Admissions Office.

Parent's or Guardian's Name:*

Prefix

First

Middle

Last

Suffix
Child #1 Name:*

Prefix

First

Middle

Last

Suffix
Child #1 Grade in Fall 2017*
Child #2 Name:

Prefix

First

Middle

Last

Suffix
Child #2 Grade in Fall 2017
Child #3 Name:

Prefix

First

Middle

Last

Suffix
Child #3 Grade in Fall 2017
Child #4 Name:

Prefix

First

Middle

Last

Suffix
Child #4 Grade in Fall 2017
Deposit & Payment
Billing Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Phone
Email*
A confirmation e-mail will be sent to the address below:
Deposit Amount (USD)*
Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code

Cardholder Name
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