Mizizi Homeschool Co-op Enrollment Form
The Mizizi Homeschool Co-op serves to support African American home-schooling parents and their children. We are a grassroots effort founded to provide families with the tools they need to successfully home-school their children.

We meet at 2600 West Broadway Wednesdays and Fridays 9 am-1 pm.
Email address *
Contact Information
Parent Name *
Your answer
Parent Phone Number *
Your answer
Parent Email *
Your answer
Second Contact Name *
Your answer
Relationship to child *
Your answer
Second Contact Phone Number *
Your answer
Second Contact Email
Your answer
Tuition
Membership payments are $150 monthly, $10 for additional children.
$75 for children attending one day a week.

Payment is due between the 1st and 10th of each month. On the 11th of the month unpaid accounts will be charged $30.

Unpaid accounts will prohibit students from attending the following month.

Tuition covers: books, snacks, guest speakers, CPR trained teachers, teaching assistants, an intimate educational setting with small group sizes and age specific content tailored to your child's needs.
Would you like to be considered for financial assistance regarding tuition? Assistance and scholarships are limited and will be given based on need and availability.
Will you be working or applying to work at Mizizi?
Homeschooling Background
Mizizi Homeschool Co-Op is not a school. This program is to give home-schooled children the opportunity to practice their skills and explore their interests in a group setting. We offer social and emotional learning opportunities as well as Pan-African Studies for children ages 2-13. Do not list Mizizi Homeschool Co-op as the educational entity homeschooling your child. Our program is here to support the phenomenal work parents are doing to educate their youth and provide a community around that effort!
What are your goals for homeschooling this year? *
Your answer
How can Mizizi help you reach those goals as a homeschooler?
Your answer
How many hours do you educate your children at home weekly?
Your answer
What curriculum do you use at home? *
Your answer
How long have you been homeschooling?
Your answer
What subjects do you most enjoy teaching?
Your answer
Child Enrolling
Mizizi Homeschool Co-Op offers programming to children 2-13 years old.
Children must be potty trained to join our youngest cohort.
All Mizizi students must be learning at home with their parent or participating in schooling on our off days.
Child's name *
Your answer
Child's birthday (Month, Day and Year) *
MM
/
DD
/
YYYY
Any allergies, dietary or health information needed to ensure their comfort and safety on site. *
Your answer
At what grade level is your child practicing Math? What are your goals for your child's learning in this subject this year? *
Your answer
At what grade level is your child practicing Reading and Writing? What are your goals for your child's learning in this subject this year? *
Your answer
What social and emotional skills is your child in need of strengthening? *
Your answer
What are some interests that your child has?
Your answer
What skills and subjects do they most enjoy and succeed at? *
Your answer
Is there anything else we should note about your child, to ensure their comfort, success and joy during our program?
Your answer
What do you most hope your child gains from this program?
Your answer
What days will your children be attending? *
Please list any individuals other than yourself and the second contact, that are able to pick up your children from the program: Name, Relationship, Phone Number
Your answer
Second Child's Name
Your answer
Child's birthday
MM
/
DD
/
YYYY
Any allergies, dietary or health information needed to ensure their comfort and safety on site.
Your answer
At what grade level is your child practicing Math? What are your goals for your child's learning in this subject this year?
Your answer
At what grade level is your child practicing Reading and Writing? What are your goals for your child's learning in this subject this year?
Your answer
What social and emotional skills is your child in need of strengthening?
Your answer
What are some interests that your child has?
Your answer
What skills and subjects do they most enjoy and succeed at?
Your answer
Is there anything else we should note about your child, to ensure their comfort, success and joy during our program?
Your answer
What do you most hope your child gains from this program?
Your answer
Third Child's name
Your answer
Child's birthday
MM
/
DD
/
YYYY
Any allergies, dietary or health information needed to ensure their comfort and safety on site.
Your answer
At what grade level is your child practicing Math? What are your goals for your child's learning in this subject this year?
Your answer
At what grade level is your child practicing Reading and Writing? What are your goals for your child's learning in this subject this year?
Your answer
What social and emotional skills is your child in need of strengthening?
Your answer
What are some interests that your child has?
Your answer
What skills and subjects do they most enjoy and succeed at?
Your answer
Is there anything else we should note about your child, to ensure their comfort, success and joy during our program?
Your answer
What do you most hope your child gains from this program?
Your answer
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