Request Membership Info.

Fill out the form below and click the Continue button at the bottom.

Please provide some basic contact info. and a volunteer will get in touch with you to answer your questions and share how to join our group. We want to use this form to give prospects a chance to request info. but it was originally developed to request website access/group membership.  We can't change the automated message you receive that confirms your request---it will sound like you've asked to join. Filling out this form is simply an imperfect communication tool for further information, not a formal request for membership. To join our group you register in person at one of our Thurs. co op classes or by mail.

Thanks!

Grace Christian Homeschoolers

 

* indicates a required field
*Last Name:
*Primary First Name:
Spouse First Name:
*Address:
*City:
*State/Country:
For United States and Canada:
For Other Countries:
State/Province:
Country:
*Zip/Postal Code:
*Area Code:
*Phone:
Phone 2:
*Email:
Additional Email Address(es):
Separate multiples with a comma.
If additional email address(es) are entered above, should they also receive weekly email and forum notifications, etc.?
Yes     No
Children:
*User Name: (must be 3-15 characters long)
*Password: (must be 3-15 characters long)
*Confirm Password:
 
Church Affiliation:
Year you Started Homeschooling:
*Weekly Email Update: Would you like to receive a weekly email update?
Yes    No
Message to Group Administrator:

Type in the text that you see above: