Individual Enrollment Form

Individual Enrollment Form

You must agree to the program polices before submitting this form. If you have not yet read them please do so here.

    Agreement

    I have read and agree to the Program & Payment Policies.

    I have downloaded and intend to mail/fax/email the Required Documents (click to download PDF) to Carlisle Academy for the current school year.

     

    Student/Contact Information

    Student:

    Date of birth:

    Parent/Legal guardian:

    Address:

    City:

    State:

    Zip:

    Phone:

    Email:

     

    Program & Tuition

    Class Name:

    Registration Deadline:

    6 or 12-Week Session: SpringSummerFall

    Tuition:

    Per Diem Rate (if applicable):

    Pro-rations/Discounts: NoYes

    The tuition (or your portion of tuition) is due by the beginning of the session. If you are unable to pay your balance at this time, please contact the office to establish a payment plan.

     

    Financial Aid

    Scholarship pending with Carlisle Charitable Foundation? NoYes

    Amount requested:

     

    Private Insurance

    Private Insurance Carrier:

    Policy No.:

    Subscriber:

    Date of birth:

    Relation to student:

     

    Scheduling

    Please indicate the day of the week and the time of day you would like to attend.
    Wednesday - AMWednesday - PMThursday - AMThursday - PM

    Specific time parameters:

    Dates unable to attend: (tuition still applies unless excused absence)

    Notes:

     

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