Home Schooling/Application

Home School Program Application

Mother's Name (required)

Mother's Email (required)

Mother's Phone

Father's Name (required)

Father's Email (required)

Father's Phone

Mailing Address

City, State, Zip

Home Phone

Does your family attend church?

Name of Church

Location of Church

Please indicate which Home School Level:
Level I - EnrolledLevel II - RegisteredLevel III - Curriculum Only

STUDENT INFORMATION

Student's Name, Gender and Date of Birth (required)

School Last Attended (required)

Last Grade Completed (required)

-------------

Student's Name, Gender and Date of Birth

School Last Attended

Last Grade Completed

-------------

Student's Name, Gender, and Date of Birth

School Last Attended

Last Grade Completed

As the mother, I have read and agree with FCS Homeschool program and understand my responsibilities as a parent in the program. (Please enter your name.)

As the father, I have read and agree with FCS Homeschool program and understand my responsibilities as a parent in the program. (Please enter your name.)

Please prove you are human by selecting the plane.