Center for Home Education Summer 2019 Registration Request
This form is only a request of registration and does not guarantee placement in any classes. You will receive a follow up email to the email address provided with further instructions after this form is submitted.
Email address *
Parent(s) First Name *
Your answer
Parent(s) Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone (home) *
Your answer
Phone (cell) *
Your answer
More Information
If there is a non-custodial parent/guardian, please also give that info also
Your answer
Payment Plan *
Which Payment Plan do you prefer? Payment plans are described in detail on our website.
New Family *
Are you a new family to The Center for Home Education?
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.