Cupertino/Pleasanton Form Term*Please select the term from the drop down menu below:Fall/Spring 2018-2019Summer 2019Campus Location*CupertinoPleasantonCourse Title*Please refer to the Course Schedule page on our website for the available course offerings.Credits*Both semesters 10 creditsFirst Semester 5 creditsSecond Semester 5 creditsStudent Name as it appears on transcripts* First Last Student's Date of Birth* Year of Graduation*201920202021202220232024Student's Grade in the Fall*12th11th10th9th8thParent or Guardian's Name* First Last Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Parent Cell*Student Cell*Which school does the student attend?*Emergency Contact Name* First Last Parent email to receive progress reports* Student Email* Referred byIf you were referred by a friend, we would like to thank the person who referred you to HBA. Please type their name below.Emergency Contact Phone (other than self)*Student lives with:* Both parents Mother Father Legal Guardian Authorization*Please click here to read the full text of our Enrollment Agreement. By checking all boxes below, you are acknowledging agreement to all school policies stated. I acknowledge that I am the parent responsible for paying the entire tuition. A $250 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. Please check it for accuracy. Once tuition has been paid, no refunds will be issued. In cases of documented emergencies, a credit will be issued. A $30 late fee will be assessed each month that the tuition is in arrears. A parent must call in absences by 8:00 am. Excessive or unexcused absences may incur an extra charge for make up classes. No grade is guaranteed. Parents may log into Thinkwave.com to check student grades. Disruptive or disrespectful behavior will not be tolerated and students who are asked to leave the course will not be refunded for that semester. Timely and thorough 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 us to use your child's image (no names) without prior consent. I agree to allow my child to be photographed for promotional purposes on the HBA website or HBA Facebook page or printed materials. Special Needs*Please contact an administrator or the teacher prior to the first day of class to discuss any modifications, health concerns, medications, or special instructions that may help us in working with your child. NoneLearning DisabilityAttention DeficitMedical IssueEmotional ConcernOtherWould 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.* No thank you. Not at this time. Yes, I will call (408) 805-0988 to schedule an appointment in Cupertino. Yes, I will call (925) 998-8609 to schedule an appointment in Pleasanton. TranscriptsPlease upload your student's unofficial transcript to complete the enrollment process. This will allow us to check for necessary prerequisites for the class in which you are enrolling. Transcripts may also be mailed or dropped off. Comments or concerns: This iframe contains the logic required to handle Ajax powered Gravity Forms.