New Student Registration 1 Student

Step Two: Registration Form One Student

The non-refundable $125 family registration fee is due with your Southeast Academy registration form. You can pay the family registration fee online or call in your payment information.  The family registration fee is separate from the first tuition payment that is typically due a week before student work begins.

For 3rd-8th grades, you do not need to decide between the four different programs at this point.

Need Help? Please call 276-496-7777 ext. 221 8am-4:30pm EST if you need any assistance.

    STUDENT INFORMATION:

    Full Legal Name (required)

    Date of Birth (required)

    Male or Female (required)

    Student Grade Level (required)

    Last School Attended (required)

    School's City (required)

    School's State (required)

    Select the program/curriculum structure for your student, if known:

    10 Month Traditional Year or 12 Month Year Round Option (required)
    For Kindergarten or Pre-Kindergarten, choose Traditional.

    PARENT INFORMATION:

    Parent Name or Names (required)

    Mailing Address (required)

    Street Address

    City (required)

    State (required)

    Zip (required)

    County (required)

    Person Responsible For Tuition (required)

    Select how you will be paying the $125 Family Registration Fee. If you will call in your payment information to pay the registration fee, please enter the day and time you will call in your payment information.

    If calling in your payment information, when will you call?
    Our telephone payment hours are 8am-4pm EST, 7am-3pm CST, 6am-2pm MST, 5am-1pm PST.

    Day you will call? (required)

    Approximate time you will call? (required)

    Email- primary not junk account (required)

    Home Telephone (required)

    Cell Phone

    START DATE AND SIGNATURE:

    Date To Start School Work

    How Did You Find Us

    Do you have a referral code?

    By entering my name in the Signature box(es), I understand and agree with the above statements and also verify the information entered is correct.

    Parent Signature (required)

    Signature Date (required)

    One last step. View the brief information on the next screen. Thank you!

    If error message when submitting, look for any uncompleted questions above and resubmit again.
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