*** CONFIRMATION PAGE***

We have received your enrollment application for and will
be processing and sending this Grade program soon.

This is the only confirmation you will receive. Please print it and retain for your records.

PLEASE NOTE:

*   Allow 7-10 business days for your initial payment to be processed.

*   Allow 3-8 weeks for Pearblossom Private School to assign courses
     and send the program to you via Priority Mail.

*   If enrolling in the 2nd semester only, please provide the name and fax of your
     previous School so we may obtain an official transcript and confirm 1st semester credits.

*   Below is a copy of your Application. Please check the credit card number,
     expiration date, 3 or 4-digit CVC Code, and amount to charge. If these
     are incorrect or blank, please hit the back arrow, correct the information
     and press SUBMIT again. If more than one application is submitted, only
     the most recent application will be used.

*   Monthly Payment is $50 until balance is paid in full.

*   On the enrollment application, you have NOT selected automatic monthly payments until
     the balance is paid in full. If you desire to make $50/month payments automatically, then please
     contact us at 1-800-309-3569 or for those outside the U.S. 601-823-9034.

Tuition Fee and Enrollment AGREEMENT: I acknowledge that there is NO guarantee that credits
earned at PPS will be transferable or acceptable by other educational institutions.
Also, a $50.00 per month additional fee is incurred for each
additional month the student is enrolled beyond the 12th month.

I, (type full name of parent/guardian) , the undersigned,
hereby authorize Pearblossom Private School K-8 to obtain a release of student information,
including transcripts, from previously attended schools. Should payment remain delinquent in
excess of ninety (90) days the student shall automatically be dis-enrolled and an additional $50
processing fee will be required to reinstate enrollment. A $15.00 service charge will be incurred
on all returned checks. An $85 fee will be incurred for each replacement text book or DVD. A
maximum limit of 12 months is allowed for the enrolled student to complete each grade.
A complete refund, less $100.00 shipping/handling or processing fee, will be issued upon
cancellation within thirty (30) days from date of receipt of books and upon return of all books
and materials. Payments must reach our offices by the 15th of each month or a late fee of $20
will be incurred.
Please allow 3-8 weeks for delivery.

The parent/guardian is solely responsible for contacting the college or
university the student plans to attend--to determine the high school courses required for entrance.
Pearblossom Private School K-8 (PPS) cumulative liability to undersigned or the student or any
other party for any loss or damages resulting from any claims, demands, or actions arising out of
or relating to this Agreement shall not exceed the enrollment tuition fees paid for the curriculum
provided. In no event shall PPS be liable for any indirect, incidental, punitive, special, or
consequential damages, including legal fees, lack of transferability of credits, loss of (a) data
by means of computer software or U.S. mail, (b) profits or revenues, (c) employment or education
opportunities, whether based in contract, tort or otherwise, even if PPS has been advised of the
possibility of any such loss or damage. I understand that PPS shall have the right to legal action
for nonpayment of tuition and fees, and the undersigned will be responsible for all costs of
collection, including court expenses and reasonable attorneys' fees. Since the attendance laws vary
from state to state, PPS urges the undersigned to check state attendance laws; PPS is not responsible
for ensuring compliance with state or local truancy laws; that is the responsibility of the undersigned.
Furthermore, the undersigned is responsible for the expense of returning and insuring the books and
accomplishing any required state testing. Regardless of state testing requirements, PPS highly
recommends the student take a nationally normed test at the parent or guardian's expense which can
often be accomplished conincident with public school testing. Accreditation and associated
requirements are subject to change without notice. Any student found to be cheating on tests will
be disenrolled immediately with NO refund or credits issued. This Agreement constitutes the entire
agreement between the undersigned and PPS and supersedes any prior agreements, representations,
proposals, or understandings, whether oral or written, with respect to the subject matter of this
Agreement. I have read and understand this Agreement as evidenced by my name and date below.

Copy of Application Submitted

Students Name:
Date of Birth:
Parents Name:
Address:
City, State Zip: ,  
E-mail Address:
Phone:
Alternate Phone:
Student Gender:
Student Ethnicity:
Student has book Young People Ask?:
I have:

For 7/8th Grade, Select Math desired:
Previous School:
Address:
City:
State/ZIP:
Fax No.:



Additional Fees:
Hands-on Art Electives:

Total of Additional Fees:
Check or Money Order Mailed:
MasterCard/Visa No: CCV:
Expiration Date:
Name on Card:
Amount to Charge:



Agreement
Name:
Book Deposit (50% non-refundable)
The undersigned hereby authorizes Pearblossom Private School Inc. to obtain a release of student
information, including transcripts, from previously attended schools.
Signature:    Date: