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Application to Join CHASE

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If you would like to apply for membership in CHASE for the 2021-2022 school year, please complete and submit the form below.

1. *

Father's First & Last Name:

2. *

Mother's First & Last Name:

3. *

Street Address:

4. *

City, State:

5. *

Zip Code:

6. *

Primary Phone:

7. 

Cell phone:

8. *

E-mail:

9. *

Father's Occupation:

10. *

Mother's Occupation:

11. *

How did you hear about CHASE?

12. *

Did you read our Statement of Faith?

Yes No
13. *

Do you agree with our Statement of Faith?

Yes No
14. *

Do you regularly attend church?

Yes No
Sometimes
15. *

Please tell us the name of your home church and how your family is involved in the church:

16. *

How long have you homeschooled and why do you choose to homeschool?

17. *

Have you been involved with another co-op?  If you have, please tell us which one(s) and your reasons for leaving.

18. *

List skills you may share with CHASE, any subjects in which you have interest or experience, and/or any classes you have taught in the past:

Children (Please include all children, even if the grade is blank.)

19. *

Child 1 Name:

20. *

Child 1 date of birth:

21. *

Child 1 Grade for the 2021-2022 School Year:

22. 

Child 2 Name:

23. 

Child 2 date of birth:

24. 

Child 2 Grade for the 2021-2022 School Year:

25. 

Child 3 Name:

26. 

Child 3 date of birth:

27. 

Child 3 Grade for the 2021-2022 School Year:

28. 

Child 4 Name:

29. 

Child 4 date of birth:

30. 

Child 4 Grade for the 2021-2022 School Year:

31. 

Child 5 Name:

32. 

Child 5 date of birth:

33. 

Child 5 Grade for the 2021-2022 School Year:

34. 

Child 6 Name:

35. 

Child 6 date of birth:

36. 

Child 6 Grade for the 2021-2022 School Year:

37. 

Child 7 Name:

38. 

Child 7 date of birth:

39. 

Child 7 Grade for the 2021-2022 School Year:

40. 

Child 8 Name:

41. 

Child 8 date of birth:

42. 

Child 8 Grade for the 2021-2022 School Year: