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Request Membership in PIONEERS Homeschool Co-op
* indicates a required answer.
Parent's Name and email address
Student's Last Name:
Student's First Name:
Student's current age and grade
Name of your Pastor:
So that we may better serve your child, does your child have any learning disabilities or dyslexia?
If yes, please explain.
Will your child be attending public school or receiving auxillary services (Speech Therapy, etc. from the public school at any time this year?
If so, how many hours/classes?