Fall 2008
Fall Session - Fremont
Please review our Fees & Policies information.
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Contact Information
Student's First Name
MI
Student's Last Name
Home Address
City
State
Zip
Home Phone
Student's e-mail
Student status
New Returning
School
Grade in Sept 2008
Mother's Name
Mother's Work Phone
Mother's e-mail
Father's Name
Father's Work Phone
Father's e-mail
Class Information
Class #1 Title
Instructor
Day/Time
ID Number
Tuition: $
Class #2 Title
Class #3 Title
Tuition Total $
Amt. Enclosed $
Balance Due $
Date of Check
Check Number
Comments or Questions
We will NOT process registration and place a student in a class UNTIL 1/2 of the tuition is received in our office.
Check or Cash: Please mail or bring tuition to: The Mill Creek Academy, LLC, 1544 Washington Blvd., Fremont, CA 94539.
Visa/MasterCard: Available by phone or in person at Mill Creek Academy, LLC office.
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1544 Washington Blvd. • Fremont, CA 94539 Phone: 510.353.0400 • Fax: 510.353.0464
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