NO FEE Enrollment Application

Liberty Learning Enrollment Application
Enrolling For?*

Immediate Start2025/2026 Program Year
Parent One Name*

First NameLast Name
Parent Two Name

First NameLast Name
Parent One Email*
example@example.com
Parent Two Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent One Phone Number*

Area CodePhone Number
Parent Two Phone Number

Area CodePhone Number
Child Name*

First NameLast Name
Child Birthdate*

MonthDayYear
Date
Grade To Be Enrolled*
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 $850 per learner, September-June. No financial assistance is available at this time.
Should be Empty:

Liberty Learning Enrollment Application