2025-26 HSV Co-op Registration Form

The Well Academy Co-op Registration Form

Huntsville - 2025-26 School Year
Name of Parent/Guardian*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse of Parent/Guardian (if applicable)

First NameLast Name
Phone Number

Area CodePhone Number
Parents' Occupation/Place of Employment*
Please provide Employer and Employer Phone Number

My Products- *Please note that your registration payment is non-refundable.

Registration Fee (per student)

$175.00 # of Students

Enter coupon

Total

$0.00

Is there anything else you would like us to know?
By submitting this application, I give consent to receive calls and/or text messages to the above phone number, not to be used for marketing purposes.
Should be Empty:

The Well Academy Co-op Registration Form