Matanzas Christian Academy
Summer School Enrollment
e-mail: matanzasacademy@comcast.net fax: 904-395-9026
Students Full Name:
Grade Level:
Age: Sex: Date of Birth: SSN:(Optional)
Street, City, St., Zip:
E-Mail: Phone#
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Parent Name/Guardian Name:
Street Address:
City, State, Zip code:
Home Phone: Work Phone
Cell Phone:
E-Mail:
PAYMENT METHOD
Cost: $350 for 1st course and $300 for each additional course.
To be completed by the end of July.
Students take and pay for one course at a time.
____ Check
____(Credit Card) Pay Pal to Ms Harris( tammilet@ yahoo.com)
Parent/Guardian/applicant Signature or Facsimile: Date:
To Be Filled out by the Guidance Department
(name of student)___________________________ has the permission of __________________________ school to take the following courses in Matanzas Christian Academy's summer school program and will accept the credits and grades given for the work accomplished.
Course _______________________ Semesters __ 1 __ 2 __ FULL
Course _______________________ Semesters __ 1 __ 2 __ FULL
Course _______________________ Semesters __ 1 __ 2 __ FULL
Course _______________________ Semesters __ 1 __ 2 __ FULL
Approved by:
Title:
Date:
