Address:___________________

Home Phone:  ____________________  Dad’s Phone:  _______________________

Mom’s Cell Phone:  ______________________   E-Mail:  __________________________

Student’s names, ages, and birthdates (only those attending):

Name:  __________________________________________________ Sex: __M __F

Birthdate:  ______/______/______      Age as of Sept. 1 __________  Grade: ______

___History            ___ Science         ___Language Arts     ___ Math         ___ Bible      ___Spanish 

                                                                Total Monthly Fee:  _____________

Polo shirt size:  YXS    YS    YM    YL    AS    AM    AL    AXL    AXXL  (circle one)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Name:  __________________________________________________ Sex: __M __F

Birthdate:  ______/______/______      Age as of Sept. 1 __________  Grade: ______

___History            ___ Science         ___Language Arts     ___ Math         ___ Bible      ___Spanish 

                                                                Total Monthly Fee:  _____________

Polo shirt size:  YXS    YS    YM    YL    AS    AM    AL    AXL    AXXL  (circle one)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Name:  __________________________________________________ Sex: __M __F

Birthdate:  ______/______/______      Age as of Sept. 1 __________  Grade: ______

___History            ___ Science         ___Language Arts     ___ Math         ___ Bible      ___Spanish 

                                                                Total Monthly Fee:  _____________

Polo shirt size:  YXS    YS    YM    YL    AS    AM    AL    AXL    AXXL  (circle one)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Cordis Academy admits students of any race, color, and national or ethnic origin.

Insurance Company: ___________________________  Policy Number: __________

Homeschool group affiliation: _____________________________________

Church you attend: ______________________________________________

Pastor’s name: _________________________________________________

Withdrawal Policies:

The Cordis Academy bases its annual budget on the number of students enrolled in the program.  We do not accept new students once classes have begun.  Therefore, parents are obligated to pay for their children for the entire school year.  Exceptions to this policy include:

ð  Death of a parent

ð  Moving more than 30 miles from a MAFA location

ð  Parent becoming unemployed

NO exceptions are given for the following reasons:

ð  Child re-enrolled in school

ð  Child is tired of the program

ð  Child has too many other activities                                                                          

Registration fee for full time students: 

                         $180.00 (January – Feb. 28), $200.00 (March-May 31)

                         $220.00 (after June 1), $240.00 (after August 1)  per students

Payment plans are available.  Registration fee cover the costs of the uniform shirt, rent, supplies, insurance, etc. needed to run the school for the year.

Tuition Payment:  Please prayerfully consider this commitment before applying.  You will be liable for payment for the full year after the August 1^st deadline.

K- 9^th grade monthly tuition payment for a full time Master’s/Masterkey/Portfolio student is $125 ($1125.00 yearly tuition)  and $145.00 ($1,305.00 yearly tuition) for students not attending Master’s Academy/Masterkey/Portfolio from Sept.-May (9 payments).  Please note that no tuition will be due in August.    A $20.00 late fee will be applied each month that the tuition is late.  Failure to pay tuition for more than two months will result in dismissal.

A la carte Tuition Payment option:

Bible - monthly tuition payment is $15.00 for a 30 minute class from Sept. – May (9 payments).  Registration fee: $20

Science - monthly tuition payment is $35.00 for a 60 minute class from Sept. – May (9 payments).  Registration fee: $40

Language Arts (Literature/Composition/Grammar) - monthly payment is $70.00 for a 120 minute class from Sept.–May (9 payments).  Registration fee: $40

History - monthly tuition payment is $35 for a 60 minute class from Sept.-May (9 payments).  Registration fee: $40

Math - monthly tuition is $35 for a 60 minute class from Sept.-May (9 payments).  Registration fee: $40

Spanish - monthly tuition is $35 for a 60 minute class from Sept.-May (9 payments).  Registration fee: $40

Tuition is due on the first Thursday of the month.  A $20.00 late fee will be applied each month that the tuition is late.  Failure to pay tuition for more than two months will result in dismissal.

My signature below indicates that I have read this brochure and understand the above rules and obligations of Cordis Academy.  It also absolves Cordis Academy from any liability if any member if my family, including myself, incurs injury while at Cordis Academy.  I hereby authorize the director to seek emergency medical assistance, if necessary, for the above named child(ren).  I understand that efforts will be made to contact me in case of emergency.

Signature: _______________________________________ Date: _________

Signature: _______________________________________ Date: _________

                               (Note, both parents must sign registration form)

Registration is on a first come, first served basis.  All applications must be received by August 1^st.  ALL registration fees are non-refundable.  Mail this form along with the registration fee to:

MAFA, c/o M. Wasby, 4633 Jefferson Ridge Way, Marietta, GA 30066

For Office Use Only:  Amount Paid: ______  Check # ________  Date Rec’d:  ______