IHS Enrollment Form

Thank you for your interest in Internet Home School! We believe you will be provided with a great experience and will have the tools and resources necesary for your child’s success. Please use the following form to begin enrolling your child with Internet Home School. Printable copies of this form will be e-mailed to you for later reference. We will contact you shortly to get started.

Student Information

Please enter the contact information of the student.

Name

Last Name

First Name

Address

Street Address

Street Address Line 2

City

State/Province/Region

Postal/ZIP Code

Country

Telephone

Home Phone

Mobile Phone

Birth

Birthplace (City, State)

Birthdate

Sex

Miscellaneous

Last Grade Completed

Student E-mail

Ethnicity Data

Ethnicity (Please choose the type that most applies.)

Special Needs

If your child has been in special education, briefly describe the nature of your child’s special needs and when they were enrolled.

Mother Information

Please enter the contact information of the student’s mother or second parental guardian.

Name

Last Name

First Name

Address

Street Address

Street Address Line 2

City

State/Province/Region

Postal/ZIP Code

Country

Telephone

Home Phone

Mobile Phone

Employment

Company Name

Work Phone

E-mail

E-mail Address

Father Information

Please enter the contact information of the student’s father or first parental guardian.

Name

Last Name

First Name

Address

Street Address

Street Address Line 2

City

State/Province/Region

Postal/ZIP Code

Country

Telephone

Home Phone

Mobile Phone

Employment

Company Name

Work Phone

E-mail

E-mail Address

Options

Please review our option sheet for details on each option.

Option

Desired Option

Promo

Optional Promotional Code

Policies

All options include on-line teachers, curriculum guides, the use of the textbooks, on-line grade book, report cards and transcripts. Families save 10% every month when two (2) or more students are enrolled.

Textbooks

The fees for shipping are based on the actual fees that the United States Postal Service charges Internet Home School. Parents pay the expense of the textbook shipment in the first monthly billing and thereafter when new materials are shipped. When you have completed a course you must return the textbooks. You will be charged the actual cost of the textbooks if they are not returned.

Billing

Parents are responsible for the processing fee and the monthly tuition at the time of enrollment. We accept Mastercard, Visa, American Express and Discover. If you choose to pay the tuition in installments you are responsible for the monthly tuition and the processing fee each month. The monthly tuition starts on the day that you sign up. We set up the tuition to run automatically on your bill date, and if the tuition is returned there is a $25.00 handling fee because of the additional time and charges incurred.

Withdrawals

We require a 30-day notice if you want to withdraw. The textbooks need to be returned and any work completed needs to be turned in for verification of grades.

I agree to the terms and conditions set forth above.

Cumulative Records Release

Please provide us with the current school information to request a transfer of student records.

Student

Full Legal Name

Date of Birth

School Name

Full Name of School

Address

Street Address

Street Address Line 2

City

State/Province/Region

Postal/ZIP Code

Country

Telephone

Fax

Please release all records for the enrolled student to us by fax at +1 (833) 400-8667, or to:

Internet Home School
2251 N Rampart Blvd Ste 150
Las Vegas, NV 89128-7640

If you have any questions, please contact our main office at +1 (833) 447-4723. We request that an official copy be faxed to us as soon as possible to transfer any credit earned from your school.

Thank you,
M. Timothy Samarin

I, the undersigned parent or legal guardian, do hereby authorize and consent to the transfer of all permanent student records and individualized education plans held on my child to the Internet Home School of Las Vegas, Nevada. I have read and understood my responsibilities as a home school parent and do hereby agree to comply with these tenets.

Copies of applications will also be forwarded to the parent’s e-mail addresses entered in the sections above for your review.