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CREDIT FORM

This Form Can Be Completed By The Parent OR Student's Counselor. The Purpose Of This Form Is To Confirm Needed Credits. Credits Earned Will Be Transferred Back To Student's Home School At The End Of The Quarter. If Parent Does Not Know The Credits Needed, And Counselor Is Unavailable, Parent May Upload A Copy Of Student's Transcript.a

Credit Form

2024 SUMMER ENROLLMENT APPLICATION - This form should be completed by Parent or Guardian. TRANSFER OF CREDITS ONLY! (If you are desiring to enroll as a BaSix FULL TIME student, do not complete this form. Complete our Year - Round Enrollment Application under the Admissions tab)

Student's Mailing Address *
Student's Mailing Address
City
State/Province
Zip/Postal

Current Transient Student's School Enrollment & Contact

School Address
School Address
City
State/Province
Zip/Postal

Suggested Course Names & Units (Units should be in a 1/2 or 1 whole format. Example Algebra I part A and B would be 1 whole unit needed. Just Part A, would be a 1/2. YOU CAN TAKE 2 FULL CREDITS TO TRANSFER BACK TO YOUR SCHOOL!

(See basixknowledge.com for list of courses offered. Click courses tab at top of site) All core courses will count (.5) in units and electives are(1) full unit.

Desired Division

PAYMENT AGREEMENT - CHECK THE FIRST BOX AND ONLY ONE OF THE OTHER BOXES THAT APPLIES: (I AGREE TO BEING BILLED/CHARGED FOR ATTENDING BASIX KNOWLEDGE ACADEMY. I UNDERSTAND THEIR IS A NO REFUND POLICY FOR ANY MEANS OTHER THAN IN THE FORM OF SERVICES RENDERED. I ALSO AGREE THAT A LATE FEE/DECLINE FEE OF $50 WILL BE ASSESSED AND MY CHILD'S ACCOUNT MAY BE LOCKED UNTIL PAYMENT IS CLEARED.

Credit/Debit Card Payment Information-- (Payment will be run by our office within 24 hours of receiving application)

Billing Address
Billing Address
City
State/Province
Zip/Postal
Country
POLICIES: YOU MUST CHECK ALL BOXES!

Parent Signature--YOUR ID IS REQUIRED. BEFORE SUBMITTING, PLEASE STOP NOW AND EMAIL A PICTURE OF YOUR ID TO RECORDS.BASIX@GMAIL.COM TO COMPLETE YOUR ENROLLMENT. THE ID MUST BE OF THE PARENT/GUARDIAN FOR STUDENT (UNDER 18).

BaSix Knowledge Academy is not held liable if courses above are not verified by Parent with Counselor. Furthermore, as the parent/guardian you are agreeing to and giving BaSix Knowledge Academy permission to administer courses above and to hold harmless BaSix Knowledge Academy and its staff from all liabilities. You are also agreeing to our no-refund policy other than in the form of services. Chargebacks and declines and late payments will be the responsibility of Parent. Student's accounts may be locked due to late payments. Final exams are not permitted to students with final balances at the end of the quarter.

Schedule a virtual appointment to speaker with an administrator regarding enrolling.