Liberty Learning Enrollment Application
Enrolling For?
*
Immediate Start
2026/2027 Program Year
Half Day TK 2026/2027
Liberty Pathways Part Time High School Program
Previous Member
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
2 digit month, 2 digit day, 4 digit year
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?
*
The cost for this program is $8,500 per year. No financial assistance is available at this time.
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