Online Enrollment Form

If you have any difficulties with this form, feel free to call us at (800) 595-2630 M-F between 9 am and 5 pm PST. Thanks.

Enter the number of students you wish to enroll next to the applicable program.

# of Students Program Tuition (including a one-time enrollment fee)
local program (annual) $4,300.00 + $100.00 (enrollment fee)
local program (bi-annual) $2,250.00 + $100.00 (enrollment fee)
local program (tri-annual) $1550.00 + $100.00 (enrollment fee)
local program (monthly) $ 400.00 + $100.00 (enrollment fee)
distance program (annual) $1,900.00 + $50.00 (enrollment fee)
distance program (bi-annual) $ 1000.00 + $50.00 (enrollment fee)
distance program (tri-annual) $ 675.00 + $50.00 (enrollment fee)
distance program (monthly) $ 175.00 + $50.00 (enrollment fee)


Please answer the following questions as completely as you can. If you run out of room or have difficulties with this form, call us at 1-800-595-2630 between 8 and 5 PST, or email at

Student Information

Student's full name

Student's Social
Security number

Student's Address

Student's Phone#

Student's Fax # (if available)

Date of birth:

Male or female?

Student's Nationality (optional)

Student's Immunization Status

Grade Level as of today:

Estimated graduation date (mo/yr):

Name of previous school

Previous school address

City, State, and Zip code

Will student
dual school?

Do you intend to earn a diploma from ALC?

Do you have any siblings currently enrolled with Alger Learning Center? If so, who?
If "yes", note that this discount will not show up on your email receipt, but it will be applied at time of billing

Please list areas of interests:

Does this student have any learning differences?
If so, please list them.

Will student have access to a computer?

Student's Email

Parent Information

  Name of male parent/guardian, address,
  home and work telephone numbers, and occupation

  Male parent/guardians educational background

  Name of female parent/guardian, address,
  home and work telephone numbers, and occupation

  Female parent/guardians educational background

Additional Student Information

 Referred by:

  If transfering, why is student transfering from his/her
previous school? Briefly explain

  Has the student ever been expelled? If yes, briefly explain.

  Has the student/family had any experience with
homeschooling/independent learning? If yes, briefly explain

 Does the student have any allergies or any other medical conditions
which ALC/IHS staff should be aware of?

 Is this student currently under doctor supervision or taking any medication?

  Does this student have specific post-graduation plans?
Are they planning on going to a community college or four-year university after graduating?
Please explain briefly

 Does this student plan on transfering credits to another elementary, middle, or high school?

 Emergency Information
Please supply someone to contact in case of emergency.
Include name, work and home numbers, and the relationship to the student.