Student Registration

Enroll your child in our home-based support program.

Student First Name *

Student Last Name *

Date of Birth *

Grade Level *

Special Learning Needs (Optional)

PWD Certificate (if applicable) Upload Person with Disability (PWD) certificate if available

Parent First Name *

Parent Last Name *

Parent Email * This will be your login username

Parent Phone *

Parent Password *

Confirm Password *

Parent PWD Certificate (if applicable) Upload Person with Disability (PWD) certificate for parent if available

Parent/Guardian Service Agreement

Please download the agreement form above, fill in your details, sign it, then scan or take a clear photo and upload below.

Upload Signed Agreement * Upload your filled and signed Parent/Guardian Agreement form (PDF, JPG, or PNG - Max 5MB)

I confirm that I have read, understood, and agree to the terms outlined in the Parent/Guardian Service Agreement.