Parent Daytime Phone Number (required):

    Today's Date:

    I am responsible for the payment of all fees for this account. I understand the registration fee is non-refundable and is to be paid each school year July 1. My student will be supervised during study time by a parent or responsible adult who will not allow the student to copy answers from the score keys. I agree to follow the procedures taught in the Parent/Supervisor Training Packet. I will keep all tests and test keys in a secure place, inaccessible to the student. I will grade the tests and return them promptly at the end of each quarter.

    I agree to these conditions:

    STUDENT INFORMATION (You may enter information for multiple students)

    Birthday (required):

    Grade (required):





    Registration Fee: $50

    We want to receive our curriculum by (required):

    Date we plan to begin school (required):

    Please send number of quarter(s) for my student(s) (required):

    Parents, August and September are our busiest months of the year. If you re-enroll during those months, you will have a longer wait to receive your curriculum. If you're in a hurry, enroll early! We begin sending out curriculum for the new school year on July 1st.

    Note: Registration and Tuition must be paid before curriculum is sent. For amounts, see price list on the Tuitions page.

    Payment Options - Please call (309) 663-4477 with credit card information.

    If your family situation doesn't fit this form, please contact MCA.