Membership Interest Form
Thank you for your interest in Meadow View Learning! Our programs reflect wholesome values, provide rich opportunities for student learning, and support the development of character.
Name of person filling out this form:
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
City/town of residence
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Please indicate which membership(s) you are interested in:
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Balanced Learning Experience - Full-Access (5 days: Mon-Fri)
Balanced Learning Experience - Part-Time (3 full days/week)
God's Green Earth
Frontier Girls troop
Afternoon Enrichment Club (Visual and Performing Arts, PE, etc)
I am only interested in Afternoon Enrichment AND I plan to use charter school funds (PE only)
How did you hear about us? If referred by a specific person, please provide name.
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If you become a member, what do you hope to get out of membership/programs?
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Please list name(s) of child(ren), ages, birth month and year, and current grade levels.
Is there anything we would need to know about your child in regards to medical, behavioral, or emotional conditions/concerns/diagnoses? (This information will be kept confidential and is used to help us determine whether we are an appropriate fit for your child’s needs and to ensure we can provide a supportive environment.)
We maintain a wholesome environment, with a modest dress code (no tank tops, bare midriffs, shoulder/back cutouts, images depicting violence, etc), and a zero-tolerance policy on profanity and aggression. Are you comfortable with these standards?
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Yes
No
Policies Agreement
Dress code, electronics, and behavior
Our learning environment is designed to promote focus, hands-on learning, and positive social interaction. Personal electronics—including tracking or communication devices such as smartwatches, cell phones, and handheld video games—are not permitted in the classroom. Parents are welcome to call the office anytime to check in on their child. Students may also use the office phone to contact parents if needed. We maintain a wholesome and respectful atmosphere. This includes a modest dress code (no tank tops, bare midriffs, shoulder or back cutouts, or clothing with images depicting violence). We also have a zero-tolerance policy for profanity and aggressive behavior. Are you comfortable with these standards?
Yes
No
The remainder of this form is for Balanced Learning Program memberships only. For all other programs, you may stop here and Submit.
Our learning program runs Sept through May, with an optional summer camp week in Please indicate your desired start date.
Please describe your child's education/schooling up to this point.
How would you describe your child's social & emotional development?
Has your child been removed from a class/program for disciplinary issues? If yes please describe.
How much screen time, if any, is your child exposed to per day/week?
Does your child have regular chores around the house that they are expected to complete daily/weekly?
On average, how many minutes per day does your child read (or is s/he read to) at home?
We teach academics as well as character virtues such as responsibility, honesty, kindness, and accountability. We learn about natural consequences and sometimes this means a student will be expected to clean up a mess they have made, redo an incomplete assignment, or replace an item that was broken due to misuse. Are you comfortable with this accountability approach?
Yes
No
Do you support students spending time outside daily, regardless of the weather?
Yes
No
To keep our program thriving, each member family supports us over the course of each semester through either a total of 5 hours of service (such as event help, cleaning, maintenance, etc) or a supply donation of about $100 in value. Is this a commitment your family is willing to make?
Yes
No
Submit
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