NEW Student Enrollment Application

1
School Year* This field is required.Which school year are you applying for enrollment?
Current Sch Yr 22-23
Next Sch Yr 23-24
2
Parent Name / Admitting Adult* This field is required.Primary parent / guardian contact.
3
Relationship to Student* This field is required.
Mother
Father
Grandmother
Grandfather
Step Mother
Step Father
Aunt
Uncle
Other
4
Cell Phone Number* This field is required.We have texting capabilities.
5
May we TEXT you?* This field is required.Primary way for Zion to keep you informed!
YESNO
6
Email* This field is required.We send information, receipts, and correspondence to this email address.
me@home.com
7
Address* This field is required.Ship to address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
8
Add a 2nd Adult?* This field is required.Any other adult that may be assisting the student with assignments.
YESNO
9
2nd Adult Information
Name (First and Last Name please)
Email Address
Cell Phone Number
Parent
Step Parent
Tutor
Sibling
Aunt / Uncle
Grandparent
Other
Relationship to student
10
I'm enrolling _______ kids.* This field is required.
1
2
3
more
11
Student 1 Information* This field is required.Start with the OLDEST student.
Full Name
Female (Girl)
Male (Boy)
Gender
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Grade in the 2022-2023 sch yr
Date of Birth
Age
No, thank you
Print-Based Program - Not an option
Pay as You Go - $30 per 30 min session
1 session per week - $100 p/mon
2 sessions per week - $200 p/mon
Tutor-on-Call Options
Previous SCHOOL's NAME
Previous SCHOOL'S PHONE Number
12
Program Choice for Student 1* This field is required.
Online Program (3rd - 12th Grade)
Combo Program (3rd - 6th Grade)
Print-Based Program (K - 3rd Grade)
13
Student 1 PICTUREOPTIONAL
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
14
Student 2 Information
Full Name
Female (Girl)
Male (Boy)
Gender
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Grade in the 2022-2023 sch yr
Date of Birth
Age
No, thank you
Print Based program - not an option
Pay as You Go - $30 per 30 min session
1 session per week - $100 p/mon
2 sessions per week - $200 p/mon
Tutor-on-Call Options
Previous SCHOOL's NAME
Previous SCHOOL's PHONE number
15
Program Choice for Student 2
Online Program (3rd - 12th Grade)
Combo Program (3rd - 6th Grade)
Print-Based Program (K - 3rd Grade)
16
Student 2 PICTUREOPTIONAL
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
17
Student 3 Information
Full Name
Female (Girl)
Male (Boy)
Gender
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Grade in the 2022-2023 sch yr
Date of Birth
Age
No, thank you
Print Based Program - not available
Pay as You Go - $30 per 30 min session
1 session per week - $100 p/mon
2 sessions per week - $200 p/mon
Tutor-on-Call Options
Previous SCHOOL's NAME
Previous SCHOOL's PHONE number
18
Program Choice for Student 3
Online Program (3rd - 12th Grade)
Combo Program (3rd - 6th Grade)
Print-Based Program (K - 3rd Grade)
19
Student 3 PICTUREOPTIONAL
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
20
Please process my Registration payment on
January
February
March
April
May
June
July
August
September
October
November
December
Month
TODAY
1
5
10
15
20
25
Day of the Month
21
Tuition Plan payment preference:* This field is required.
Full Year up front
Monthly - Auto Pay
22
Please process my 1st Tuition Payment on* This field is required.PAY IN FULL - process date OR Monthly Tuition begins on date. School Year starts mid August and ends late May.
January
February
March
April
May
June
July
August
September
October
November
December
Month
TODAY
1
5
10
15
Day of the Month
23
I prefer my remaining Tuition payments to be on the ____ of each month.* This field is required.
1st
5th
10th
24
Occasional INCIDENTAL Fees - (most common)

$50 Late Assignment

Up to 12 per school year depending on your time of enrollment. A schedule of the Deadline Review days is provided at enrollment and can be found on our School Calendar. This fee is ONLY due IF the student is behind on their assignments on one of the scheduled review days.
25
I prefer Late Assignment Fees to be processed ...* This field is required.Incidental fee due only if a student misses a Deadline Review Date.
Automatically (best)
Email an Invoice
26
By policy, we will not ask for credit card information on any online form. This ensures your card information is kept safe.

Please call us to give the full card information and verify dates for processing.
27
Terms and Conditions* This field is required.Please read carefully. Withdrawing before the end of the school year incurs a $250 fee or the remaining tuition, whichever is less.
28
Please verify that you are human* This field is required.
29
Signature* This field is required.
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