MEMBERSHIP APPLICATION

First name(s) of parent(s)

Last name of parent(s)

Phone

Address

Church home

Student's first name

Age

Grade

Birthday (dd/mm/year)

Student's first name

Age

Grade

Birthday (dd/mm/year)

Student's first name

Age

Grade

Birthday (dd/mm/year)

Student's first name

Age

Grade

Birthday (dd/mm/year)

Student's first name

Age

Grade

Birthday (dd/mm/year)

If you have additional children, please list first name(s), age(s), grade(s), birthday(s) here: ____________________________________________________________________________________________________

For JH/HS students only: please list the current Math & Science curriculum you're using at home or co-op. For example: Shormann Algebra 1 or Apologia Biology ________________________________________________________________________________________________________________________________________________________________________________________________________

Name of previous co-op

Dates attended

Name and phone number of leader

Your educational background:

Please list subjects and grade levels you're willing to teach.

Please list two references that we may contact. These should be people who are not family members and who can address your character, as well as your teaching and homeschooling experience.

Name of reference

Relationship

Phone

Name of reference

Relationship

Phone

How did you learn about Character Co-op?

After visiting Character Co-op, do you have any concerns that need to be addressed?

What is it about Character Co-op that makes you want to join?

Are you involved in extracurricular groups that would occasionally affect your co-op attendance (sports, debate, robotics, etc.)?

Is your student currently receiving any type of therapy (behavior, speech, vision, occupational, etc.)?

Does your student have any learning challenges or specific educational needs that may impact his / her learning or classroom experience while at co-op? (Please note that as much as Character Co-op would love to help all students, we are not equipped to handle children who have learning challenges, whether that be an accelerated learner or delayed learner.)

If invited to participate in Character Co-op, I understand that I am committing to:

1. Attending Co-op on the scheduled days and times throughout the school year.

2. Teaching in at least one class, and assisting in one or two classes.

3. Completing a cleaning job that may extend the day to 3:45.

4. Helping in one other area to support the co-op such as yearbook, party planning, making coffee, etc.

5. Paying yearly family co-op fees and other possible nominal class fees.

6. Taking only one pre-planned absences during the school year (not including illnesses).

7. Understanding and agreeing to abide by Character Co-op's Mission Statement, Statement of Faith, Family Covenant, and Teacher Guidelines.

8. Placement testing for your student for certain high school classes if deemed necessary.

Parent's first name

Parent's last name

Date (dd/mm/year)

(The $25 application fee is non-refundable, but if you join Character Co-op, the amount will be applied to your annual family fee. Please send payment via Paypal to CharacterTreasurer@gmail.com.)

Thanks for submitting!