Churchville Christian School
2016 – 2017 Application to the Homeschooling ProgramParents Names: ______
Mailing Address: ______Street City State Zip Code
Contact Phone # (______)______Additional Phone # (______)______
Date you will be starting Homeschooling? ______E-mail Address: ______
Home Church: ______County of Residence: ______
Ø Thank You for choosing CCS. Please print clearly with dark ink, and return this page only with front and back (course material plan) completed. Keep the CCS Information pages for your records.
Ø Has your family ever been enrolled with Churchville Christian School in the past? ______Previous CCS Family ID# ______
Ø Are you a member of the Home School Legal Defense Association? ______Best time of the day to contact you? ______
Ø How long have you been homeschooling? ______How did you hear about CCS ______
Ø Please describe the program you intend to use: A prepared curriculum ____ Design our own curriculum ___ Unschoolers ____
Ø Please file a Homeschool Notification Form with your local Board of Education once you have received a letter of confirmation of enrollment from Churchville Christian School. Search online for Maryland Homeschool Notification form, or contact your local Board of Education.
Student Information
Full Name
/Date of Birth
/ Grade / Gender (M/F)Confirmation of Application
In making application to Churchville Christian School, we acknowledge that we have read, and agree to abide by, the school’s Policies.
______
Signature of the father Signature of the mother
Both parents must sign before mailing (unless a single parent).
New Enrollment Fee
New Enrollment Fee $85.00, due with application. Please make checks payable to Churchville Christian School, and mail to Churchville Christian School, P.O. Box 534, Churchville, MD 21028.
New Enrollment Periods (May 1, 2016 – March 31, 2017)
FOR OFFICE USE ONLY:
Pre-Enrollment Conference: ______Date: Amt.
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