First and Last Name

Address

City / State / Zip

Phone Number

E-mail Address

How long have you been homeschooling?

Will you be able to attend for the entire 2023-2024 school year? If not, why?

How did you hear about our co-op? Please list the names of any members you know.

List other homeschool programs or co-ops you plan to be involved in during the upcoming school year.

List your children who would attend co-op by names, ages, and grades, including any younger Nursery or Toddler children. (please list age and grade they will be for the time period you are applying to join during)

List any special needs or delays any of your children have (e.g., Down's syndrome, autism spectrum, sensory issues, learning disabilities, dyslexia, attention, behavioral, or social issues, speech/language deficits, hyperactivity, other). This information will be kept confidential. We welome children of all abilities and this information will only be used to learn how we can better support you.

List the areas in which you are able to contribute to the co-op, including classes you are willing to teach.

List any additional information that would be relevant to the co-op's consideration of your application.

If you do not agree with our statement of faith, could you explain in your own words your particular disagreement with it and/or how you will uphold our beliefs? (If you do agree with our statement of faith, mark N/A) View the Statement of Faith here.

By checking the box below, I attest that all statements made on this application are accurate and complete. I understand that submitting false statements or withholding relevant information will result in the denial or dismissal of my membership. I also understand that if I accept a membership offer, I am making a commitment to the co-op for the entire school year.