I-HERC ACADEMY
a division of
Internet Home Education Resource Center

 

APPLICATION FOR ENROLLMENT

FOR SCHOOL YEAR ______________ - ______________

LAST NAME: _________________________________ HOME PHONE: ______-______________

FATHER'S FIRST NAME: _________________________________________________________

Years of School Completed: 8, 12, 14, 16 POST GRADUATE

MOTHER'S FIRST NAME _________________________________________________________

Years of School Completed: 8, 12, 14, 16 POST GRADUATE

HOME ADDRESS: ________________________________________________________________

CITY: _____________________________________________ STATE: ____ ZIP: ___________

WORK ADDRESS: _______________________________ WORK PHONE: ______-______________

REFERRED BY: _________________________________

ENROLLMENT: One-time family enrollment fee of $50.00. ACADEMIC TESTING & CONSULTATION: Initial diagnosis and prescription fee of $20.00 per child

NAMES OF CHILDREN IN FAMILY ENROLLING AGE GRADE BlRTHDATE
1. ______________________________________ ____ ____ __________
2. ______________________________________ ____ ____ __________
3. ______________________________________ ____ ____ __________
4. ______________________________________ ____ ____ __________

NAMES OF CHILDREN WHO ARE CURRENTLY USING OR HAVE USED THE .A.C.E. CURRICULUM:

____________________________________________________________________

NAMES OF CHILDREN WHO WILL NEED TO BE TESTED USING THE DIAGNOSTIC TESTING PROCEDURES:

____________________________________________________________________

 

For grades 1-12 simply send the application form along with the $50.00 family enrollment fee and $20.00 testing fee for each student you wish to enroll in I-HERC Academy. We will send you the proper Diagnostic Tests. When the tests have been completed, return them to us for scoring and analysis. An academic advisor will call to discuss proper prescription to meet the individual needs of your child/children and will help you with specific curriculum.

Preschool and learning-to-read (kindergarten) students may also be enrolled. Please call for further information on enrollment, testing, and curriculum.

We are here to work with the home in helping parents give their children a quality education. For those enrolled, I-HERC Academy provides educational consultation, maintenance of records, forms, CAT testing, and a graduation program with diploma upon completion of prescribed high school studies. Students will be accepted regardless of race, creed, or color, and as they will agree to the policies and rules of I-HERC Academy.

"I agree to uphold and support the high academic standard of I-HERC Academy by providing a place at home for my child to study and by encouraging my child in the completion of required work. I appreciate the standards of the educational ministry and do not tolerate profanity, obscenity in word or action, dishonor to the Godhead or the Word of God, disrespect to authority, or disrespect or dishonor to the American flag or government. I understand that I-HERC Academy reserves the right, after parental conference, to dismiss any child who fails to comply with the established regulations or whose parents do not assume their responsibility to the parent agreement.

"Furthermore, I understand the tuition plans and agree to pay the amount, as set forth in the I-HERC Academy Tuition Program worksheet, by the MONTH, QUARTER, SEMESTER, or YEAR (circle one). I also understand that service fees are due the 25th of the designated month and will be considered late after the 1st of the following month. A late charge will be assessed for late payments.

________________________________________
Signature of Father		 ________________________________________
Signature of Mother
_____________________________
Date		 _____________________________
Date

**Please make checks payable to I-HERC. The enrollment fee, testing and consultation fee, and tuition paid are non-refundable.

Enrollment Form | Quality Education Form | Student Record Release | Tuition Program | Registration