Returning Member Form

Once your Returning Member Form has been submitted, we will contact you with more information. We look forward to welcoming you back to CHFM!

*Mother Name

Father Name

Mother Occupation/Degree Father Occupation/Degree

*Address *City *Zip

*Phone

Cell

*Email Address

*Emergency Contact Name *Number

Number of Years Home Schooled

Where did your children attend school prior to home schooling?

Name of Group Group Contact Name

When were you a previous CHFM member?

*Family Attends Church at Member: Yes No

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

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

*Required

I understand and agree to the following:

I understand that to become an active member for the Fall 2010 session I must attend a MANDATORY informational meeting on August 26, 2010 at 2:00 p.m.

This returning member form must be submitted by July 21, 2010.