Courses for Credit Enrollment Form Enrollment Agreement for Courses for Credit (Universal) Term*Please Select Term from the drop down menu belowSummer 2017Fall 2017Spring 2018Course Title*Please select from the drop down menu below:ChemistryAP ChemistryBiologyPhysicsAP Physics 1Algebra 1GeometryAlgebra 2Math AnalysisHonors PrecalculusAP Calculus ABAP Calculus BCMath AMath BIntegrated Math 1Integrated Math 1 HonorsIntegrated Math 2Integrated Math 2 HonorsIntegrated Math 3Integrated Math 3 HonorsIntroduction to CalculusSpanish 1Spanish 2Spanish 3Spanish 4World HistoryUS HistoryEnglish 9-12Other CoursesIf the course you want is not listed in the drop down box above, please type the name of the course herePeriod/Time: For Fall/Spring classes, please choose the period and for Summer classes choose the time. Please select from the drop down menu below:*Fall/Spring: Chemistry Period 1Fall/Spring: Chemistry Period 7Fall/Spring: Physics Period 2Fall/Spring: Physics Period 6Fall/Spring: Biology Period 1Fall/Spring: Biology Period 2Fall/Spring: Honors Precalc Period 1Fall/Spring: Honors Precalc Period 7Fall/Spring: Honors Precalc Period 6Fall/Spring: AP Calc AB Period 1Fall/Spring: AP Calc BC Period 2Fall/Spring: AP Statistics Period 6Fall/Spring: Integrated Math 1 Period 2Fall/Spring: Integrated Math 2 Period 1Fall/Spring: Integrated Math 2 Period 7Fall/Spring: Integrated Math 3 Period 7Fall/Spring: Econ/Gov Period 1Fall/Spring: US History Period 1Fall/Spring: US History Period 6Fall/Spring: World History 2Fall/Spring: Spanish 1 Period 1Fall/Spring: Spanish 2 Period 7Fall/Spring: Spanish 3 Period 2Fall/Spring: Spanish 4 Period 6Summer: Chemistry 8-11amSummer: Chemistry 11:30am-2:30pmSummer: Physics 11:30am-2:30pmSummer: Biology 8-11am (FULL)Summer: Biology 11:30am-2:30pmSummer: Integrated Math 1 10:30am-1:00pmSummer: Integrated Math 2 10:30am-1:00pmSummer: Integrated Math 3 8-10:30amSummer: Algebra 2 TBDSummer: Geometry TBDSummer: Honors Alg2/Trig TBDSummer: Math Analysis 10:30am-1:00pmSummer: Honors Precalculus 8am-10:30amSummer: Spanish 2 12:30pm-2:30pmSummer: Spanish 3 10:00am-12:00pmSummer: Spanish 1 2:30-4:30pmSummer: Spanish 4 8am-10amOther/TBDFOR SUMMER CHEMISTRY ONLY!! Do you prefer the Alternative Option?STUDENTS MAY TAKE THE FIRST SEMESTER FROM JUNE 26 – JULY 14 AND TAKE THE SECOND SEMESTER 3 WEEKS LATER: AUGUST 7 – 25 (8:00 – 11:00) Yes No Student Name (as appears on transcripts)* First Last Student's Date of Birth* Year of Graduation*2016201720182019202020212022Student's grade in Fall 2017*9th10th11th12thParent or Guardian Name* First Last Mailing Address* Street Address City ZIP Code Parent Cell*Student CellStudent's school to receive transcript*Parent Email to receive progress reports* Student email*How did you hear about us?*My child has already attended HBAMy child's sibling has attended HBAWe were referred by friends.We were referred by school staffWe found High Bluff on the internet.We saw an ad in the newspaper.We received a flyer in the mail.We would like to thank the person who referred you to HBA so please type their name below.Emergency Contact Name (other than self)* First Last Emergency Contact Phone (other than self)*Credits*Both semesters 10 credits (equal to full year)Semester 1 only 5 creditsSemester 2 only 5 creditsWho does the student live with?* Both Mother Father Authorization*Please click here to read the full text of our Enrollment Agreement. Please acknowledge that you are aware of the following policies by checking all boxes below: I acknowledge that I'm the parent responsible for paying the entire tuition. A $200 non-refundable deposit is required to reserve a seat in any class The tuition balance due date and confirmation of course details will be stated on your invoice which will be emailed to you within 3 business days of submitting your deposit. Once tuition has been paid, no refunds will be issued. In cases of documented emergencies, a credit will be given. A $25 late fee will be assessed (the charge will recur each month) if payment is not received by due date. A parent must call in absences by 8:00 am Excessive or unexecused absences may incur an extra charge. No grade is guaranteed. Parents may log in to Thinkwave.com to check student progress and to communicate with the teacher. Please contact us if you do not receive log-in instructions the first week of class. Disruptive or disrespectful behavior will not be tolerated. A full refund will be given if a student is asked to withdraw from the program. Completion of homework is mandatory. Photo Release*From time to time we take pictures of class activities to post on our website or Facebook page. We would appreciate it if you would allow use to your child's image (no names) without prior consent. I agree to allow my child to be photographed for promotional purposes on our website, Facebook page, or printed materials Reason for taking this course:* Remediate Prior Grade Accelerate to next course in sequence HS Graduation Requirement Special Needs*Please contact an administrator or the teacher prior to the first day of class to discuss any modifications, medications, or special instructions that may help us in working with your child.NoneLearning DisabilityHealth concernADD/ADHDWould you like to meet with the Director to discuss your child's academic needs or to develop an academic plan? This service is free for HBA clients. If yes, please call us at (858) 509-9101 to set up an appointment with our Director.No thank you. Not at this time.Yes, parent will call (858) 509-9101Transcripts*Please upload your student's unofficial transcript to complete enrollment (An unofficial transcript can be found on your student's Aeries account). Transcripts will allow us to check for necessary prerequisites for the class for which you are enrolling. Is there any information you would like to share with us?