Enrollment Application Grades 7–12
Complete one Enrollment Application and Agreement per student.
ENROLLMENT SELECTION
7–12 Full Grade
Tuition $725
Choose a Grade:
Video Streaming or
7th
8th
9th
10th
11th
12th
DVD
Accredited
I would like Digital Textbooks. (Mark your choice of Digital Textbooks as you select courses below.)
Yes, I would like to receive free standardized testing.
Opt out of free standardized testing.
I would like Digital Assessments.
Independent Study
Books $270
I have the books or will purchase them separately.
Pay in Full
Payment Plan $250* Down Payment
*Payments for Tuition only = 6 X $84.16
Payments for Tuition and Books = $6 X $129.16
Payment plan includes $30 service charge.
5
Additional Course over 6 credits Tuition = $110
Additional Course over 6 credits Books = $70
Same Grade (This child will be in the same grade as another one of my children who is enrolled in A Beka Academy. See page 11 for details.)
Tuition
Books
$465
$140
Additional Course Tuition
Additional Course Books
$110
$70
Accredited
Independent Study
Please fill out separate application
for each additional child.
Select Courses: Full Grade = up to 6 credits. Course value in parentheses for grades 9–12.
Select Digital Textbooks if applicable: Each Digital Textbook is available for a 12-month license period.
7th Grade**
8th Grade**
9th Grade
10th Grade
**Accredited 7th and 8th gr. must take all courses listed under
respective gr. (8th gr. choose one math course only).
Bible 7
English 7
World History 7 ©2015
Bible 8
English 8
U.S. History 8
Earth and Space Science
Course Selection
Digital Textbook
Life Science
Digital Textbook
Basic Math
Physical Education
11th Grade
English 10 (1)
World Geography (.5)
World History 10 (1)
Digital Textbook
Biology (1)
Physical Science (1)
Algebra 2Y (1)
See complete book listing on pages 22–29.
Algebra 1 (1)
Physical Education 1 (1)
Electives
New Testament (.5)
Revelation (.5)
English 11 (1) ©2015
English 12 (1)
U.S. History 11 (1)
American Gov. (.5)
Consumer Math (1)
Business Math (1)
Spanish 1 (1)
Spanish 2Y (1)
Speech (.5)
Chemistry (1)
Economics (.5)
Plane GeometryY (1)
PrecalculusY (1)
Digital Textbook
Digital Textbook
Digital Textbook
Digital Textbook
Digital Textbook
Digital Textbook
Digital Textbook
Digital Textbook
Digital Textbook
PhysicsY (1)
Digital Textbook
IMPORTANT: Begin date for new/revised
courses must be on or after 8/10/15. To
receive earlier versions, begin date must be
on or before 6/15/15.
Digital Textbook
Health (.5)
Old Testament (.5)
Digital Textbook
***Accredited—must have a documented A
in 7th gr. math (select one math course)
Digital Textbook
Digital Textbook
12th Grade
Digital Textbook
Digital Textbook
English 9 (1)
Life Management (.5)
Digital Textbook
Bible Doctrines (1)
Digital Textbook
Digital Textbook
Pre-Algebra
Algebra 1***
Physical Education
Digital Textbook
Hebrew History (1)
Keyboarding (1)
Document Processing (.5)
Family / Consumer Sciences (.5)
Y
Honors
Digital Textbook
Home Ec.—Sewing (.5)
Physical Education 2 (1)
Orchestra 1 (.5) DVD Only
Orchestra 2 (.5) DVD Only
Violin
Cello
Digital Textbook
Viola
Bass
PAYMENT
PAY IN FULL________________________________________
DOWN PAYMENT________________________________________
TOTAL________________________
Totals
TAX/GST‡________________________
OTHER AMOUNT________________________________________
–$50
–$50
New Student Discount expires 8/3/15*
–$____
Military Discount
Early Enrollment Discount expires 6/26/15*
‡ TAX= Sales Tax/GST Rate _____ X Book Value ______
Tax amount is charged at point of sale according to delivery address in: AL, AR, AZ, CA, CO,
CT, DC, FL (Independent Study Only), GA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MO, MS,
NC, ND, NM, NV, NY, OH, OK, PA, RI, SD, TN, TX, VA, VT, WA, WI, WV, WY, and Canada.
Tax will be charged on the Book Value.
* See inside cover for details.
I would like to receive paper statements.
Payment Method
Check Enclosed for $__________
Driver’s License No. needed for check payment:
(Make check payable to A Beka Academy, Inc.)
Must be drawn on U.S. bank with U.S. funds.
No postdated checks, Returned checks subject to service fee.
_____________________________________________________
Cardholder’s ZIP Code
Charge $___________ Visa R MasterCard R DiscoverR
Required for processing credit card order: credit card number, expiration date, security code,
–
ZIP Code, and cardholder’s name
Expiration Date:
Month –
Credit Card Number
Security Code:
Year
Last 3 digits from back of card
Automatically charge my credit card on the following day of the
month for monthly balance (circle one below)
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
Office
Use
Only
X_______________________________________________________________
Cardholder’s Name (Please print.)
Date Received _______________
Batch No. _____________ Cash or Ck. No. _____________ Amount _________________ Appl. No. ______________
5
Enrollment Application Grades 7–12 cont.
Complete one Enrollment Application and Agreement per student.
Please read ordering information and Terms and Conditions (pp. 11–13) before filling out this application.
General
Information
Account
Info
ENROLLMENT INFORMATION
New Enrollment
Expires 2 / 29 / 2016
Re-enrollment
Preferred Begin Date
Account No.
Month
Day
Year
Student ID No.
Father (last, first)_________________________________________ Mother (last, first)_________________________________________________________
Parents separated or divorced?
No
Yes, child lives with:
Legal Guardian: Father
Mother
Other
(Fill out information below.)
Name of Legal Guardian: (last, first)__________________________________ Relationship to student_______________________________________
(If Legal Guardian is not father or mother, legal documentation of guardianship may be required before application is processed.)
Additional Contact to access Account: (last, first)______________________ Relationship to student_______________________________________
(optional)
Church Name_____________________________________________ Church Denomination______________________________________________
Physical street address required for all shipments. (Day phone no. required for timely delivery.)
Shipping
Address
Street Address______________________________________________________________________________________________________________
City _______________________________ State/Province_________________ ZIP/Postal Code ________________ Country___________________
Phones
(
)
(
)
Home_____________________________________
Day____________________________________________________________________
Correspondence
Address
Work _____________________________________
(
)
(
)
Cell____________________________________________________________________
E-mail _____________________________________________________________________________________________________________________
Same as Shipping Address above
Street Address_____________________________________________________ P.O. Box_________________________________________________
City _______________________________ State/Province_________________ ZIP/Postal Code ________________ Country___________________
Student
Information
Student Legal Name____________________________________________ Date of Birth_______________
Male
Female
Complete the following if enrolling in Accredited Program:
If grade 9–12, does student plan to receive a diploma from A Beka Academy, Inc.?
Yes
No
List previous school:
School____________________________________________________ Phone___________________________________ Fax________________________
Street Address / P.O. Box__________________________________________________ City / State_____________________________________________
ZIP_________________________ Country_____________________________________ Last grade completed___________________________________
Will student be enrolled in another program while enrolled in A Beka Academy, Inc.?
Yes—attach letter of explanation
No
Yes—list grade(s) repeated____________
No
Has student ever repeated a grade?
ENROLLMENT AGREEMENT
REP APP
MUST BE SIGNED AND DATED
Student’s Legal Name__________________________________________________________________________________
I am enrolling the above-identified student in A Beka Academy, Inc.,
H o m e s c h o o l P ro g r a m . I u n d e r s t a n d t h a t e n ro l l m e n t m a y b e t e r m i n a t e d o r s t u d e n t re c o rd s w i t h h e l d a t a n y t i m e a t t h e d i s c re t i o n o f
A Beka Academy, Inc., because of noncompliance with guidelines or failure to keep
my account current. A Beka Academy, Inc., reserves the right to deny enrollment
to any student who does not meet admission requirements. A Beka Academy is
not available to residents of Pensacola, FL, and the immediate surrounding area. I
understand that A Beka Academy, Inc., does not discriminate on the basis of race,
color, or national origin. I understand it is my responsibility to meet all applicable
local and state homeschool requirements and I acknowledge my responsibility to
select the course of study (K–12) needed to meet any applicable homeschool graduation requirements in my state. It is my responsibility to contact my local school
district to determine if there are any additional requirements in my state for children who are homeschooling. I understand that accreditation is a voluntary process
which verifies that A Beka Academy meets reliable education standards. However,
it does not guarantee the acceptance of credits since each institution or state
creates its own policies of credit transfer. Some schools may require additional validation of academic achievement. (I confirm that I understand and am responsible
for complying with the contents of the A Beka Academy, Inc., Homeschool Enrollment and Academic Terms and Conditions and specifically the policies regarding
academics, cancellations, late work, and late DVDs.) I understand that the instructional videos remain the unconditional property of A Beka Academy, Inc., and that
A Beka Academy shall retain all right, title, and interest, including without limitation
all intellectual property rights, in and to the videos. I shall not copy, modify, license,
reverse engineer, or create derivative works of the videos. I understand that the
materials on the videos are only for the use of the above-identified student during
the term that the student is enrolled and only for purposes associated with the A
Beka Academy course of study, and such materials may not be retained or further
disseminated in any format. Other than the limited right to use the videos for the
express purposes herein, no rights of any nature, express or implied, are granted in
the videos or their content. I agree not to sell, lend, or duplicate the video content
or allow another child to view any portion of the videos on a regular basis and I
agree that the right to use this program is not transferable. I understand that DVDs
must be returned to A Beka Academy, Inc., and if all DVDs are not returned before
my assigned end date, I will be charged a $400 late DVD return fee. Delinquent
accounts will not be eligible for the payment plan option on future enrollments.
Prices are subject to change without notice. Books are the unconditional property
of the user and cannot be returned for credit after 30 days. If return is made,
credit will not be issued, nor return made to sender. A Beka Academy, Inc., is not
liable for damage to a customer’s equipment. This agreement is governed by the
laws of Florida. This agreement does not become effective until accepted by an
authorized representative of A Beka Academy, Inc.
Signature of Parent or Legal Guardian
Print Name Here
Date
6
SAVE TIME — ENROLL ONLINE
abekaacademy.org