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Application Form:

PLEASE READ BEFORE BEGINNING APPLICATION:

You must use a computer - application doesn't work on a phone.

The application must be completed start to finish in one session. If you aren't ready to make the application payment do not continue.

If your student has previously taken courses at MSE, don't complete this application. Instead send an email to [email protected] with your student's full name. Instructions for accessing the system will be sent.

Do not sign up weeks or months in advance.

Do not sign up for both semesters of a year long class at the same time.

Student's email address needs to be unique - not mom or dad's email address. Once you submit this application please make sure your student regularly checks their email. We use email to communicate with students.

Complete and submit the following application form to apply to Market Square Education.

*The application fee is non-refundable.*

Student Information

Student First Name *

Student Last Name *

Middle Name

Gender *

Date of Birth *

Grade Level *

Address

Street *

City *

State *

ZIP *

Student Email *

Student Phone

Race *

Primary Parent/Guardian Information (With Whom the Student Resides)

First Name *

Last Name *

Email *

Phone *

Alternate Parent/Guardian Information

Secondary Parent/Guardian

First Name

Last Name

Email

Phone

Additional Information

Counselor

School of Origin