Discipleship Co-op New Student Application
Please complete the form below to apply to Discipleship Co-op. Thank you for your interest!
Father's First Name *
Your answer
Father's Last Name *
Your answer
Father's Occupation/Company *
Your answer
Father's Parental Expertise:
Because we sometimes need computer help, legal advice, organizational help, etc. from our parents, please share with us any areas of expertise you believe might be beneficial to the Discipleship Tutorial:
Your answer
Father's E-mail
Your answer
Father's Work Phone *
Your answer
Father's Cell Phone *
Your answer
Mother's First Name *
Your answer
Mother's Last Name *
Your answer
Mother's Occupation/Company *
Your answer
Mother's Parental Expertise:
Because we sometimes need computer help, legal advice, organizational help, etc. from our parents, please share with us any areas of expertise you believe might be beneficial to the Discipleship Tutorial:
Your answer
Mother's E-mail *
Your answer
Mother's Work Phone *
Your answer
Mother's Cell Phone *
Your answer
Home Phone *
Your answer
Home Street Address *
Your answer
Home City *
Your answer
Home State *
Your answer
Home Zip Code *
Your answer
Children *
Please list names and ages of all children:
Your answer
Emergency Contact Name: *
Your answer
Emergency Contact Relationship to Student(s): *
Your answer
Emergency Contact Phone Number: *
Your answer
Church Family: *
Your answer
Homeschool Entity: You MUST be registered with an umbrella school, your local education agency (LEA) or an accredited online program to participate in our co-op. Name of your umbrella school or other entity: *
Your answer
What subjects are you doing at home, and what curriculum are you using: *
Your answer
Do you have older students registered with Discipleship Tutorial: *
How did you find out about Discipleship Co-op? *
Your answer
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