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Pearblossom Private School, Inc. ENROLLMENT APPLICATION
*** Please provide copy of birth certificate,a small photo of enrolled student for our records, and transcript of High School credits earned ***
Parent's Name
Student's Name
Address
Date of Birth
City
State
Zip
E-Mail Address:
Student has a computer? Yes No
Student SSN:
Phone
Student has book Young People Ask? Yes No
Driver's License No.
Check if you have Win95 or higher
 No Computer
Place in the desired grade:
Elementary Grades
Middle
High School Grades
K
1st
2nd
3rd
4th
5th
6th
7/8th
9th
10th
11th
12th
11/12th
*Tuition
$425 $425 $425 $425 $425 $425 $425 $800 $725 $725 $725 $725 $800
**Book Deposit
$0 $0 $0 $0 $0 $0 $0 $200 $150 $150 $150 $150 $150
Down Pmt.
$225 $225 $225 $225 $225 $225 $225 $600 $475 $475 $475 $475 $550
No. of Pmts.
4 4 4 4 4 4 4 8 8 8 8 8 8
Montly Pmt.
$50 $50 $50 $50 $50 $50 $50 $50 $50 $50 $50 $50 $50
Monthly Fee for Late Payment
$20 $20 $20 $20 $20 $20 $20 $20 $20 $20 $20 $20 $20
Teacher's Editions Answers in back of the workbooks Not Available.
*Tuition does NOT include the Book Deposit which is also required.
**Book Deposit is refunded only upon completion of all scheduled payments and return of all text books in good condition.
For 7/8th Grade:
Select Math Desired General Math Pre-Algebra
Select Science Desired Earth Science Life Science
For High School:
Previous High School Address
City
State & Zip
Fax No.



Additional Fees:
Illustration Library (v3.0) $25 CD-ROM version of Illus. Lib. $35 Spiral-bound Book of Illus. Lib. $10 Scripture Recall game $10 Publisher Exact Record Keeper (PERK)
180-pg. Journals $40 Medical Veritas, Vol 1, Issue 1 $40 Medical Veritas, Vol 1, Issue 2 $40 Medical Veritas, Vol 2, Iss. 1 $40 Medical Veritas, Vol 2, Iss. 2
Supplemental CD's $35 for Elementary $50 for Grades 7-12 Math $50 for Grades 7-12 Learning Resource
Foreign Language CD's $75 Spanish $75 French $75 Italian $75 German
Hands-on Art Electives $75 Draw Today $100 Paint Today
$100 Sculpt Today
$25 for INJECTION! 220-pg book on vaccines $20 for Past Newsletters with grade level expectations
Parelli Horsemanship Level 1: $300 Partnership Kit Level 2: $400 Harmony Kit Level 3: $200 Refinement Kit Parelli Support Library DVDs $25 ea.
Total of Additional Fees: $ If paying by CHECK or Money Order, print this form and send with check - DO NOT SUBMIT
MC/Visa/Discov/AmEx/Debit No. Expiration Date:
Name on Card Amount to Charge: $

Tuition Fee and Enrollment AGREEMENT: I, , have enclosed $ (theinitial tuition payment ortuition amount in full) plus additional fees (if any). The undersigned hereby authorizes Pearblossom Private School, Inc. to obtain a release of student information, including transcripts, from previously attended schools. Should payment remain delinquent in excess of ninety (90) days the student shall automatically be dis-enrolled and an additional $50 processing fee will be required to reinstate enrollment. A $10.00 service charge will be incurred on all returned checks. A $60 fee will be incurred for each replacement text book. A maximum limit of 12 months is allowed for the enrolled student to complete each grade. A complete refund, less $50.00 handling fee, will be issued upon cancellation within thirty (30) days from date of enrollment and upon return of all books and materials. Payments must reach our offices by the 15th of each month or a late fee of $20 will be incurred. Please allow 4-6 weeks for delivery. Pearblossom Private School, Inc. (PPS) cumulative liability to me or the student or any other party for any loss or damages resulting from any claims, demands, or actions arising out of or relating to this Agreement shall not exceed the enrollment tuition fees paid for the curriculum provided. In no event shall PPS be liable for any indirect, incidental, punitive, special, or consequential damages, including legal fees, loss of data by means of computer software or U.S. mail, profits or revenues, employment or education opportunities, whether based in contract, tort or otherwise, even if PPS has been advised of the possibility of any such loss or damage. I understand that PPS shall have the right to legal action for nonpayment of tuition and fees, and I will be responsible for all costs of collection, including court expenses and reasonable attorneys' fees. Since the attendance laws vary from state to state, PPS urges me to check my state attendance laws so that I may be in compliance. PPS is not responsible for ensuring compliance with local truancy laws; that is the responsibility of parents or guardians. Furthermore, parents or guardians are responsible to accomplish any required state testing at their expense. Regardless of state testing requirements, PPS highly recommends the student take a nationally normed test at my expense which can often be accomplished coincident with public school testing. Any student found by PPS to be cheating on tests will be disenrolled immediately with NO refund or credits issued. This Agreement constitutes the entire agreement between me and PPS and supersedes any prior agreements, representations, proposals, or understandings, whether oral or written, with respect to the subject matter of this Agreement. I have read and understand this Agreement as evidenced by my name and date below.

            Signature:                   Date:
 

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Pearblossom Private School, Inc., Quality Educational Programs Grades K-12 Since 1988