Success Center for Learning
Student Registration Form
Fall 2009

 Fill out this form and send to Success Center
Student's Name:
 Parent's Name:
Address:
  Work Phone:
Phone:
 Cell Phone: EMail:
Please enroll my child in the following program(s):
  Preschool Reading Reading

Writing

Math
  Algebra 1 Geometry PACE/MTC


Student Ratio:

Fall SCHEDULE
Schedule Request: Please indicate your preference for instructional hours
by checking the appropriate boxes. Requests will be granted based on
availability of the hours. Students who have been attending morning instruction should let us know immediately what afternoon hours they prefer for fall. Those students already attending afternoon hours need to confirm if they want the same hours for fall. Requested hours are first come, first serve.
Monday

4:00PM
5:00PM
6:00PM		 Tuesday

4:00PM
5:00PM
6:00PM *
  Wednesday

4:00PM
5:00PM
6:00PM		 Thursday

4:00PM
5:00PM
6:00PM *

* Open with Sufficient request only.
ATTENDANCE POLICY
Absence/Make-up policy
Consistent attendance is critical to progress. If a student must be absent from a scheduled session without prior notification, that session and tuition are forfeited unless there is an emergency which is relayed to a Success Center staff member. Excused absences are called in by noon during the week and before 8:00 a.m. on Saturdays.
Make-ups must be done within 30 calendar days of the excused absence.

We have found that these policies are necessary to provide consistency in learning and to maintain our excellent quality service. Thank you for your understanding and help.

I understand and agree to comply with the financial, absence, and make-up policies of Success Center for Learning.