STAR Application

2024-2025 STAR Application Form

Please fill out one application per family. Please make sure to fill it out completely, as all of the information requested is important.
Family Information
Parent 1 Name*

First NameLast Name
Parent 1 Email*
example@example.com
Parent 1 Phone*
Please enter a valid phone number.
Date

MonthDayYear
Date
Parent 2 Name

First NameLast Name
Parent 2 Email
example@example.com
Parent 2 Phone
Please enter a valid phone number.
Please note which parent(s) want to be on the STAR email list:

MomDadOther
Mom's Birthday:
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you read the STAR Statement of Faith and Statement on Marriage and Gender, and do you agree with it? https://lynchburg.starhomeschool.org/statement-of-faith/

YesNo
Tell us about your family's faith:
What church do you attend?
What is your experience with homeschooling?
Share what you know about the Charlotte Mason method of homeschooling (if you don't know about it, that's okay!):
Why are you interested in joining STAR Homeschool Community?
Have you read the STAR Family Expectations, and do you agree to these expectations? https://lynchburg.starhomeschool.org/family-expectations/

YesNo
Student Information

Please fill out the information for each enrolled student and child who will be in the nursery or on campus. If you have more than 6 children to enroll, please fill this out with 6 and then make a note in the extra space at the bottom that you have more children to enroll.
Student 1:
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Student's Age by 8/28/24
Student's Form (Grade):
Student Contact Information (if applicable):

Phone NumberEmail Address
Student 2:
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Student's Age by 8/28/24
Student's Form (Grade):
Student Contact Information (if applicable):

Phone NumberEmail Address
Student 3:
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Student's Age by 8/28/24
Student's Form (Grade):
Student Contact Information (if applicable):

Phone NumberEmail Address
Information About Your Children:
Previous School Experience (for each child):
Learning Struggles (list all per child):
Behavioral Concerns (list all per child):
Medical Information
Insurance Company
Insured
Policy Number
Pediatrician
Medical Issues (list all per child):
Do you or any of your children have any anaphylactic food allergies that require an epipen?

YesNo
Food Allergy Details (note which allergies are anaphylactic, if any, and who)
Emergency Contacts
Emergency Contact 1

NamePhone Number
Emergency Contact 2

NamePhone Number
Emergency Contact 3

NamePhone Number
People Permitted to Pick Up Your Children (Other than Parents)
Name

First NameLast Name
Name

First NameLast Name
People Expressly Not Permitted to Pick Up Your Children
Name

First NameLast Name
Name

First NameLast Name
Some Details:
All new STAR Families will need to participate in a Family Interview. Do you understand that?

YesNo
STAR teens are required to volunteer multiple times throughout the school year for set up, clean up, and playing the piano. Set up begins at 8:30 am. Clean up begins at 1:00 pm. Playing piano for hymns happens at 12 am. A schedule will be made to include all STAR families. Which of the time frames works best for you? (Choose all that apply)

8:30 am Set Up12 pm Piano Playing1:00 pm Clean Up
Payments to STAR Homeschool are non-refundable except in special circumstances (and will be voted on by the STAR board). STAR payment plans must be paid through the end of the payment plan regardless of whether or not the student continues with the classes. Do you understand this?

YesNo
All STAR Moms, Dads or Grandparents who stay on campus will have a background check done. We do these through Protect My Ministry. The STAR Application fee covers 1 background check per family. Additional background checks will cost $15 per person. Do you understand?

YesNo
Which Blocks would you like to sign your student up for? Note that Block 2 includes our core subjects and it is required. Each block is $400, plus a $50 science lab fee for Block 3.

Block 1Block 2Block 3
Additional Comments:
My Products
prevnext( X )
Application Fee (Per Student)This is required to secure your family's spot at STAR for the 2024-2025 school year. Tuition payments will also be required by July 15, 2024. This fee is nonrefundable.
$75.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

2024-2025 STAR Application Form

Family Information

Student Information

Student 1:

Student 2:

Student 3:

Information About Your Children:

Medical Information

Emergency Contacts

People Permitted to Pick Up Your Children (Other than Parents)

People Expressly Not Permitted to Pick Up Your Children

Some Details: