Maple Glen Learning Enrollment

Complete the form below to enroll your student with Maple Glen Learning. Once submitted, you'll receive a welcome email with next steps, login details, and important dates. We’re excited to support your student’s learning journey!

Parent 1 Name*

First NameLast Name

Parent 1 Email*

example@example.com

Parent 1 Phone Number*

Please enter a valid phone number.

Relationship to Student*

MotherFatherLegal GuardianOther

Please Specify Relationship to Student

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is this students primary address?*

YesNo

Parent 2 Name

First NameLast Name

Parent 2 Email

example@example.com

Parent 2 Phone Number

Please enter a valid phone number.

Relationship to Student*

MotherFatherLegal GuardianOther

Is Parent 2 address different?

YesNo

Parent 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student1 Name*

First NameLast Name

Student1 Preferred

Student1 Grade*

Student1 Date of Birth*

Date

Enroll another student?*

YesNo

Student2 Name*

First NameLast Name

Student2 Preferred Name

Student2 Grade*

Student2 Date of Birth*

Date

Enroll another student?*

YesNo

Student3 Name*

First NameLast Name

Student3 Preferred Name

Student3 Grade*

Student3 Date of Birth*

Date

Enroll another student?*

YesNo

Student4 Name*

First NameLast Name

Student4 Preferred Name

Student4 Grade*

Student4 Date of Birth*

Date

Curriculum Options*

Monthly PaymentsSelect the number of students in each category

$19.00

Grade Level	# Students	Price
Pre-K		$19.00
Kindergarten-5th Grade		$29.00
6th-12th Grade		$39.00

Annual Payment OptionSelect the number of students in each category

$228.00

Grade Level	# Students	Price
Pre-K		$228.00
Kindergarten-5th Grade		$348.00
6th-12th Grade		$468.00

Credit Recovery/RemediationUp to 1 subject at a time

$20.00 # Students

Tutoring - Subscription Up to 1 hour a session

$37.00

	# Students	Price
Up to 1x/month		$37.00
Up to 3x/month		$105.00

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Afterpay

Anything else we should know?

Ongoing Enrollment:
Your child will remain enrolled in Maple Glen Learning until you provide written notice of withdrawal. If you wish to withdraw your child
from the program, you must notify us in writing and complete the withdrawal process. Failure to do so will result in continued monthly tuition
charges.

Changes to Terms:
Highlands Educational Services reserves the right to change these terms at any time. Any updates will be communicated to you promptly.
By completing the enrollment process, you acknowledge that you understand and agree to these terms.
By enrolling, you agree to pay the monthly curriculu, fees, which will be automatically charged each month to the payment method you provide.
Tuition fees are due monthly and are non-refundable. Fees will be incurred over 12 months for each academic year, regardless of whether courses
is in session, including any breaks or holidays.
See our fees page for all possible costs.

Non-Payment of Tuition:
If your account is not paid up to date, we reserve the right to suspend access to your child’s records and the learning management system
(Canvas) until the outstanding balance is paid in full. Your child’s records will be held and inaccessible until the full payment has been received.
Re-enrollment and access will be granted once all dues are cleared.

Service Continuation:
Access to all course materials, assignments, and student progress will continue until the tuition is not paid, at which point access will be revoked
until the account is paid in full.

Payment Information:
You are responsible for ensuring that your payment information is up-to-date. If your payment fails or is declined, you will be notified, and access
will be suspended until the payment is successfully processed.