Liberty Learning Enrollment Application
Enrolling For?
*
Immediate Start
2024/2025 Program Year
2025/2026 Interest List
Parent One Name
*
First Name
Last Name
Parent Two Name
First Name
Last Name
Parent One Email
*
example@example.com
Parent Two Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent One Phone Number
*
-
Area Code
Phone Number
Parent Two Phone Number
-
Area Code
Phone Number
Child Name
*
First Name
Last Name
Child Birthdate
*
-
Month
-
Day
Year
Date
Current Grade
*
What school does your child currently attend?
*
Please tell us a little bit about your child.
*
Does your child have any special learning needs?
*
Monthly fees are $630 per learner, September-June. No financial assistance is available at this time.
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