ENROLLMENT AGREEMENT FOR PRIVATE COURSES FOR CREDIT Enrollment Agreement for Private Courses for Credit Term*Fall 2023Spring 2024Summer 2024Course Title*Student Name (as appears on transcripts)* First Last Year of Graduation*2022202320242025Student's grade in Fall 2021*7th8th9th10th11th12thParent or Guardian Name* First Last Address* Street Address City ZIP Code Parent Cell*Student CellStudent's school to receive transcript*Parent Email to receive progress reports* Student Email*needed to access ThinkWave our grading softwareStudent's Date of Birth* MM slash DD slash YYYY How did you hear about us?*My child has already attended HBAMy child's sibling has attended HBAWe were referred by friends.We were referred by school staffWe found High Bluff on the internet.We saw an ad in the newspaper.We received a flyer in the mail.Emergency Contact Name* First Last Emergency Contact Phone*Credits*Both semesters 10 credits (equal to full year)Semester 1 only 5 creditsSemester 2 only 5 creditsAuthorization*Please click here to read the full text of our Enrollment Agreement. Please acknowledge that you are aware of the following policies by checking all boxes below: A parent must call in absences by 8:00 am More than Two absences will incur an extra charge of $80/hour. No grade is guaranteed. Parents may log in to Gradelink.com to check student progress and to communicate with the teacher. Please contact us if you do not receive log-in instructions the first week of class. Disruptive or disrespectful behavior will not be tolerated. A full refund will be given if a student is asked to withdraw from the program. Completion of homework is mandatory. You will receive a class schedule of all sessions on or prior to the first day of class. Up to 3 sessions may be rescheduled with at least 24 hour notice without penalty. No shows or cancellations less than 24 hours in advance will incur a penalty of $70. Students must complete their course within two weeks of the scheduled end date or an extra charge may be incurred. Students who do not complete homework and thus are unable to keep pace with the course, or have excessive absences and rescheduling requests may not be able to finish the course on time. Photo Release*From time to time we take pictures of class activities to post on our website or Facebook page. We would appreciate it if you would allow use to your child's image (no names) without prior consent. I agree to allow my child to be photographed for promotional purposes on our website, Facebook page, or printed materials No, please contact me for permission before using my child's image Special Needs*Please contact an administrator or the teacher prior to the first day of class to discuss any modifications, medications, or special instructions that may help us in working with your child.NoneLearning DisabilityHealth concernADD/ADHDTranscriptsPlease upload your student's unofficial transcript to complete enrollment. Transcripts will allow us to check for necessary prerequisites for the class for which you are enrolling. Max. file size: 50 MB.Would you like to meet with the Director to discuss your child's academic needs or to develop an academic plan? This service is free for HBA clients. Yes, please contact me to set up an appointment. No thank you. Not at this time. Private Course Disclaimer* The course must be completed by the specified end date, which will be given once the schedule has been determined. If the student requires additional sessions beyond the completion date, an additional fee of $80 per hour will be charged. Students are allowed to reschedule their sessions only twice in a semester. Additional rescheduling for any reason will be billed at $80 per session. No show appointments will be included in the contracted number of sessions and additional charges will be added to complete the course work CAPTCHA Δ
