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 and submit the student contract you received. You are not officially enrolled until you pay your deposit.

Parent's or Guardian's Name:*

Prefix

First

Middle

Last

Suffix
Child #1 Name:*

Prefix

First

Middle

Last

Suffix
Child #1 Grade in Fall 2018*
Child #2 Name:

Prefix

First

Middle

Last

Suffix
Child #2 Grade in Fall 2018
Child #3 Name:

Prefix

First

Middle

Last

Suffix
Child #3 Grade in Fall 2018
Child #4 Name:

Prefix

First

Middle

Last

Suffix
Child #4 Grade in Fall 2018
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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