Information

indicates a required answer

1. *	Name

2. *

How many years have you been Homeschooling?

(1 required)

Considering Homeschooling		Brand new to it!
1 Year		2 Years
3 Years		4 Years
5+ Years

3. *	What are the ages of your children?

4. *	What curriculum / program / teaching style do you use?

5. *

Have you read through our information page?

(1 required)

Yes

No

6. *	How did you hear about SHIELD?

7. *	Questions/Comments:

8. *	E-mail Address:

9.	Phone Number: