Please complete a separate registration for each student.
Name of the Parent/Learning Coach
Student's Name
Parent/Learning Coach's Email
Parent/Learning Coach's Phone Number
Address
City, State
Zip Code
Student's Gender
Student's Grade
Student's Age
Which session are you registering for at this time? Choose all that apply.
The Uplifting Education Complete Academic Enrollment includes four core courses. Please specify which courses or leave it blank if you'd like to discuss it during your initial consultation. If you'd like one of the free electives ask for one in the comment box.
Language Arts Course
Math Course
Science Course
Social Studies Course
Additional Core Courses require a fee of $50 each.
Additional Core Course (Use the comment box to request more than one additional core course.)
The parent/learning coach corrects subjective assignments such as writing and offline worksheets. If you would like extra writing support for the Language Art/English course, the fee is $180 for one session or $170 each for more than one session. Check which session(s) you would like the extra writing support:
High School Elective Courses are an additional $180 for one or $170 each for more than one. Do you want to add an elective course? (If so, please state which one(s) in the comment box.)
How will you be using this enrollment?
How did you find out about Uplifting Education?
Comments:
Choose one -- If your child is 13 years old or under, please read the statement regarding the use of personal information in compliance with COPPA on this website: http://upliftingeducation.net/coppa-privacy-statement.php
If you are enrolling more than one student, after you submit this form, press your browser's back arrow to return to this form so you only have to change the necessary fields. By submitting this enrollment, you acknowledge that you are the parent or legal guardian of the student and that it is your responsibility to abide by all state or national laws. Failure to do so will not be the fault of Uplifting Education in any way. Although Uplifting Education gives suggestions or links for more information, Uplifting Education is not a substitute for legal advice. Furthermore, Uplifting Education does not guarantee admittance or transfer to any school or scholarships of any kind.
