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1. *

Last Name:

2. *

First Name:

3. *

Email Address:

4. *

Phone Number:

5. *

How long have you been homeschooling?

6.*

1st Child's Grade

 (1 required)
Nursery PreK
K 1st
2nd 3rd
4th 5th
6th 7th
8th 9th
10th 11th
12th
7.*

1st Child's Gender

 (1 required)
Male Female
8.*

2nd Child's Grade

 (1 required)
Nursery PreK
K 1st
2nd 3rd
4th 5th
6th 7th
8th 9th
10th 11th
12th Not Applicable
9.*

2nd Child's Gender

 (1 required)
Male Female
Not Applicable
10.*

3rd Child's Grade

 (1 required)
Nursery PreK
K 1st
2nd 3rd
4th 5th
6th 7th
8th 9th
10th 11th
12th Not Applicable
11.*

4th Child's Grade

 (1 required)
Nursery PreK
K 1st
2nd 3rd
4th 5th
6th 7th
8th 9th
10th 11th
12th Not Applicable
12.*

4th Child's Gender

 (1 required)
Male Female
Not Applicable
13. 

Additional Children's Grade & Gender

14. *

Church Affiliation

15. 

Do you know anyone currently in CrossPointe co-op?  If so, please tell us who.

16.

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