Request for Info
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If you would like to send a request for more information,  please fill out and submit the following On-Line .  You can also download the complete enrollment packet, print the forms, and mail them in with your payment.  Our staff will contact you with your enrollment confirmation.

If what you want to tell us is really more of a suggestion or a request for enhancement, please use our suggestion form instead.

Online Questionnaire Form

When you submit your form, it will be entered into our database for tracking purposes.  We will contact you by mail or e-mail.  

Please be as thorough as possible when filling in this questionnaire.

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Request for Information

   1.   Name of Student 

   2.   Birth Date           3.   SSN 

   4.   What Grade are you in or will you be entering?

   5.   Last School Attended 

   6.   Mother's Name     

   7.   Mother's Address         

   8.   Place of Employment 

   9.   Work Number    10. Home/Cell 

 11.   Father's Name     

 12.   Father's Address 

 13.   Place of Employment 

 14.   Work Number    15. Home/Cell 

 16.   Church Affiliation

Please write in 3 - 5 sentences explaining your reasons for deciding to homeschool, Include your future plans, (i.e., will you continue to homeschool, or will your student return to public or private school sometime in the future:

                   

   Please provide us with the following information in case we need to contact you:
  Name:    
  Phone:   
  E-mail:

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