Limited Time Offer: Get 2 Months of ABCmouse.com for only $5!

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Easy Sign Up

When you are ready to sign up, simply print this page, fill it out and bring with you when you set up a time to meet with Mrs. Glenn. Your first visit will be a get acquainted session and  time to set up a schedule.

 

Student Name:___________________________Age:________Grade:___________

 

Parent Name:______________________________________________

 

Address:___________________________City______________State____________Zip__________

 

 

Phone Numbers:________________________________

 

Is this application for   ____Home School Assist   or   ____Student Assist (public school attendee) 

Area of interest for assist (circle all that apply):    math      reading     writing     language arts    

                                                                                       foreign language (specify___________)  science

                                                                                                social studies      phonics       spelling       art   

                                                                                           physical education (PE)          Biblical Studies

                                                                                          other (specify________________)

 

__________________________________________________________________________________________________________________________

                                                                                                                                        To be filled in by HLC

 

       Schedule:   M    T    W    Th     F               Time:_________to_______________               

 

       Start Date:_____________________

 

                                                  Payment:   ______each week             ______upon completion of each session

 

    initials_______ 

Get 2 Months for $5!