Prospective Member Form

Once your Prospective Member Form has been submitted, we will contact you to schedule a consultation. We look forward to meeting you!


*Mother Name  

Father Name  

Mother Occupation/Degree Father Occupation/Degree

*Address *City *Zip



*Email Address

*Emergency Contact Name   *Number 

Number of Years Home Schooled

Where did your children attend school prior to home schooling?

Have you been a member of a homeschool group before?
Name of Group Group Contact Name
Name of Group Group Contact Name

*Family Attends Church at Member: Yes   No 

*Child's Name *Birth Date (xx/xx/xxxx) *Grade *Male / Female  
 M   F  
 M   F  
 M   F  

*Do you and your spouse have a growing relationship with the Lord?    

*Briefly explain.


CHFM is a cooperative effort and parents are frequently responsible for assisting the instructors in a class setting. What strengths will you bring to CHFM?


Do you have any special areas of expertise?


Any outstanding strengths or weaknesses in your children?


CHFM is a structured and intense program that requires a high degree of work and commitment. What would you like or not like about CHFM ?


*Do you foresee any problems fulfilling your commitment?

*Why do you desire to be a part of CHFM?



 I understand and agree to the following:

I understand that to become a new member I must attend a MANDATORY informational meeting at the beginning of the semester.
This prospective member form must be submitted by Monday, November 27, 2017.