Registration

Primary Parent's Phone *

(###)

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Secondary Parent's Name

First Name

Last Name

Secondary Parent's Phone

(###)

###

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Payment Options *

100% Self-Pay

Howell - Family will enroll

Undecided

Why Homeschool? *

Which of the following are reasons you are registering for the hybrid program. Choose up to three.

The hybrid model is ideal for our family.

A hybrid option helped me take the leap into homeschooling.

I'm not comfortable teaching every subject on my own.

I want my child to build friendships.

I’m looking for an alternative to public school because of COVID-19.

I need time to refresh.

Other

Student #1 Date of Birth *

MM

DD

YYYY

Student #2 Date of Birth

MM

DD

YYYY

Student #3 Date of Birth

MM

DD

YYYY

Student #4 Date of Birth

MM

DD

YYYY

Student #5 Date of Birth

MM

DD

YYYY

Student #6 Date of Birth

MM

DD

YYYY

Payment Options *

Howell - Family will enroll

100% Self-Pay

Undecided

Student #1 Date of Birth *

MM

DD

YYYY

Student #2 Date of Birth

MM

DD

YYYY

Student #3 Date of Birth

MM

DD

YYYY

Student #4 Date of Birth

MM

DD

YYYY