Home-School ASL Class
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Course Facilitator ~ Mrs. Shelby Miller
Classes held in New Braunfels, Texas
Student Registration Form
If you are enrolling more than one student, you must complete this form for each individual student.
Students Full Name *
First, Middle, and Last
Students Gender *
Students DOB *
01/01/****
Academic Grade Level *
2020-2021 enrolling year
Parents Names *
Physical Address *
Please list your full address, to include your city and zip
Parent Contact Number *
Student Contact Number *
I encourage students to text or call with questions, as they need to
Parent Email Address *
Parent's primary communication address for class information, course progress, updates, and homework help
Students Email Address (Cannot be the same as parent email) *
This is required for student access to the online course interface
Course Student is Enrolling in *
Required
Tuition for Single Student
Registration Fee - $35.00

PAID IN FULL PAID BY SEMESTER PAID MONTHLY
ASL I $1250.00 $625.00 / Semester $125.00 / Month
ASL II $1250.00 $625.00 / Semester $125.00 / Month
Multi-Family Discount
Registration Fee - $35.00 for each student enrolling

ASL I

Student 1 - $1250.00 / Full $625.00 / Semester $125.00 / Monthly
Student 2 - $1150.00 / Full $575.00 / Semester $115.00 / Monthly
Student 3 - $1050.00 / Full $525.00 / Semester $105.00 / Monthly

ASL II

Student 1 - $1250.00 / Full $625.00 / Semester $125.00 / Monthly
Student 2 - $1150.00 / Full $575.00 / Semester $115.00 / Monthly
Student 3 - $1050.00 / Full $525.00 / Semester $105.00 / Monthly
Registering More Than One Student From Your Household?
This is Student Number (this is for the mutil-family discount)
Registration Fee (Non-Refundable) *
Due immediately to hold students place within the class
Required
Course Tuition *
Choice of Payment Plan
Required
Tuition (Only Payable by Cash or Check) *
Fall Semester -or- 1st monthly tuition installment is due by August 5th. If registering after this date, tuition is due no later than August 24th - at Back-To-School night.
Required
Comments
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