Bitterroot Family Homeschool Waitlist
Parent/Guardian:
*
First Name
Last Name
Parent/Guardian Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Email:
*
example@example.com
If you are part of a local church body where do you fellowship?
Student Name:
*
First Name
Last Name
Student Birth Date:
*
/
Month
/
Day
Year
Date
Student's Age by September 30th 2024 (Register all your children attending including babies)
*
Student Name:
First Name
Last Name
Student Birth Date:
/
Month
/
Day
Year
Date
Student's Age by September 1st 2024
Student Name:
First Name
Last Name
Student Birth Date:
/
Month
/
Day
Year
Date
Student's Age by September 1st 2024
Student Name:
First Name
Last Name
Student Birth Date:
/
Month
/
Day
Year
Date
Student's Age by September 1st 2024
Student Name:
First Name
Last Name
Student Birth Date:
/
Month
/
Day
Year
Date
Student's Age by September 1st 2024
Do you have more than 5 children who would attend co-op? Please list names and birthdays of additional students
Is there any other information about your family or children that would be helpful for us to know? This is a good place to share if you are expecting and what month he/she would be due.
Where would you be able to help serve in the co-op?
*
Sprouts Class (Ages 2-3)
Cubbies Class (Ages 4-5)
Beavers Class (Ages 6-8)
Grizzlies Class (Ages 9-11)
Flamingos Class (Ages 12+)
Interested in teaching a class in the future
Have questions about other places to serve
Who referred you to the co-op?
*
First Name
Last Name
Reference #1 (This can be anybody you know who would vouch that your family would benefit our co-op)
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference #2 (This can be anybody you know who would vouch that your family would benefit our co-op)
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please verify that you are human
*
Submit
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