Hilger Higher Learning REGISTRATION

Hilger Higher Learning – Registration Form 2008-2009

www.hhlearning.com

General Information ** please complete one for each child** Phone: 706.820.1983

Parent’s name ____________________________________________________________

Student’s name ___________________________________________________________

Mailing Address __________________________________________________________

City ____________________________________ State ________ Zip _______________

Telephone: (_____)____________________ Email: ________________________

(This address will be used for billing purposes)

Cell Phone: (_____)____________________

Grade level of your child (in the Fall) _____ Age _____ Umbrella School:_________________

Father’s occupation ________________________________________________________

Mother’s occupation _______________________________________________________

_______Please check here if you would like to receive your bill thru the postal service. We will be using your email address for billing purposes each month, unless you otherwise specify here.

We bill most of our families each month for the 10 month cycle. However, if you prefer to pay by the semester or year, please check the corresponding box: ______ semester ______ year

Special Information

Does your child have any learning deficiencies? _____ If so, please explain on the back of this page.

** This information will be kept strictly confidential...our knowledge of any area in which your child struggles will simply help us serve him/her better in the classroom.

“Round Up” Scholarship Opportunities and Financial Aid

Hilger Higher Learning seeks to provide a quality education to everyone who could benefit from our courses. In order to provide this service, we need families who are willing to sponsor other families financially. If you would like to provide scholarship money for a family, please initial below:

_____ I would like for you to “round up” my bill to the nearest $5 increment.

_____ I would like to sponsor a family in the specific amount of $_________ per month.

_____***If you are one of the families who has a specific financial need in order to participate in our courses, please initial here. Someone will contact you concerning your need.

Payment Guidelines: Please initial each of the following

_____ I agree to pay 10 equal monthly payments, beginning in August and ending in May. Invoices are sent out VIA EMAIL (this is a new procedure) around the 5^th – 10^th of each month and due upon receipt, so please plan on paying mid-month.

_____ I understand that my invoice is DUE UPON RECEIPT and is considered LATE if Hilger Higher Learning does not receive my monthly payment by the last day of the month. I will be charged a $10 late fee if my check is not received by the end of the month, or if I have not contacted HHL to make other arrangements.

_____ I understand that all checks must be sent to Hilger Higher Learning or dropped in the “in-box”, located in the teacher’s office of the church.

_____ I agree to pay a $15 charge that will be placed on any returned check.

_____ I understand that payment is required for each class, even if my child is absent.

_____ I agree to pay a $75 charge per class if I withdraw after the second week of class. This INCLUDES dropping at the end of the semester; unless the class is only one semester.

_____ I understand that all registration fees and payments are non-refundable (with the exception of a class not forming or a class time changing).

Course Information: Visit our website at www.hhlearning.com

Please fill out the following information for the courses you have chosen for your child. Course schedules and registration fees can be found on our website (www.hhlearning.com). Registration fees for each class must be sent in along with your registration form.

Course Chosen Day and Time Registration Fees

________________________ ________________ ___________

Total registration fees to be sent in with registration form: ____________

Agreement Information

We, the parents of __________________________________ (student’s name) have read and are committed to the guidelines stated in this form. We understand that our child/children are attending classes at First Alliance Church at their own risk. We do not hold Hilger Higher Learning, First Alliance Church, or any teacher affiliated with Hilger Higher Learning responsible in any way.

Signed by parent ______________________________________ Date ____________

Signed by student ______________________________________Date ____________

You will be sent an acceptance letter (containing rules, regulations, textbook information, and a calendar of events) once your registration form has been processed and accepted. Please do not purchase books until you have been accepted via a letter or phone call.

Hilger Higher Learning 1121 Mountain Terrace Lookout Mountain, GA 30750 Ph. 706.820.1983

Questionnaire

Please fill out ONE per family even if you’ve been with us for several years!

Hilger Higher Learning reserves the right to refuse any student for acceptance into our program. We strive to keep the caliber of our students high and the environment of our program positive and encouraging for all of the students enrolled. In order to do that, we would like for you to fill out this questionnaire which will provide us with some important information about your family. Before doing so, please read over our requirements and make sure they are in line with what you are seeking to do in the home.

All parents and students are required to meet the following criteria:

The student must conduct himself/herself in a manner worthy of the gospel of Christ.
The student must contribute to his/her class setting in a positive way.
The parent must be completely involved in every subject the student takes from Hilger Higher Learning.
The student must complete all homework on a consistent basis.
The student must not have excessive absences.
The student’s grades must reflect his/her ability.
The student must leave the church premise (parking lot included) after class, unless otherwise supervised by an adult or if they have another class within the allowed 15-20 minute window.

*** If these criteria are not kept throughout the year, we reserve the right to ask the student to discontinue classes with Hilger Higher Learning.***

1. How many years have you been involved in homeschooling?

2. What are the reasons you have chosen to homeschool your child (children)?

3. Who is the primary teacher in your child’s academic day?

4. What days and subsequently how many hours will they be taught by the primary teacher?

Hilger Higher Learning 1121 Mountain Terrace Lookout Mountain, GA 30750 Ph. 706.820.1983

6. Does the primary teacher work? If so, is it part-time or full-time? Please specify how many hours per week.

7. Do you have any inclination or plans to send your child to school (public or private) later on in the future? If so, what time frame (i.e. 6 months, 1 year, 3 years, etc) and why?

8. Has your child ever been involved in smoking, drinking, or drugs? If yes, please explain.

9. Has your child ever been suspended, expelled, or asked to withdraw from a public or private school? _________

If yes, please give the reason (if more room is needed, please use another piece of paper), how long ago and how you and your spouse disciplined your child during this situation.

Health and Emergency Information

Drug and other allergies: ______ YES (list below) _____ NO

______________________________________________________________________________

Taking Medications: _______ YES (list below) ______ NO

______________________________________________________________________________

Past Medical History and/or other pertinent Information you think HHL ought to know about:

______________________________________________________________________________

Hilger Higher Learning 1121 Mountain Terrace Lookout Mountain, GA 30750 Ph. 706.820.1983