School Registration

Please download, fill in and print out the registration form and send it to Space Coast Education Center with the appropriate supplemental documentation as explained in the form.

Download Registration Form

Student's Name:

Billing Information:

First Name:

Middle Initial:

Last Name:

Email:

Phone:

Address:

City:

State:

Zip Code:

Country:

Upload PDF:

Browse

Only PDFs are supported.
Maximum upload size PDF: 64 MB

Description:

Payment Information:

Amount:

Card Type:

Credit Card #:

Expiration Month:

Expiration Year:

CVV2:

Prove you are human:

By Submitting this form, I confirm that the information I have provided is correct to the best of my knowledge and I Authorize Space Coast Education Center to withdraw funds from the card account I've entered above.

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Call: (321) 308-8000

28th

ANNIVERSARY

28th ANNIVERSARY

• Since 1991 •

Student's Name:

Billing Information:

Payment Information:

Newsletter:

Videos:

Location:

STUDENT / ALUMNI

GUEST

SOCIAL MEDIA

HELP/INFO

1070 S Wickham Rd,
West Melbourne, FL 32904

CALL: (321) 308-8000 EMAIL:

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School Registration

Student's Name:

Billing Information:

Payment Information:

Newsletter:

Videos:

Location:

STUDENT / ALUMNI

GUEST

SOCIAL MEDIA

HELP/INFO

1070 S Wickham Rd, West Melbourne, FL 32904

CALL: (321) 308-8000 EMAIL:

Get Information Form

1070 S Wickham Rd,
West Melbourne, FL 32904