MCS Registration Form

MCS Registration Form
Name

First NameLast Name
Last School Attended, City and State or Country
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Program of Interest
Payment Options

Credit Recovery $860.00Home School $950.00In School (3 month term) $1900.00Application Fee $100.00Technology Fee $100.00Transcript Fee $50.00Express Mailing $40.00Verifications $70.00Graduation Ceremony $350.00 (With Diploma Cap /Gown)
I will be making a payment for in the amount of
I understand I have 3 months to complete this agreement/Contract Unless stated by the director in writing .
**Please make payment arrangements with the school's Director**
Should be Empty: