Application for Course Registration
Academic Year 2025 - 2026
Please fill out the below information to register your student for the 2025 - 2026 academic year. Please note that registration will not be complete until payment is processed and the additional forms required are completed and returned. The additional forms will be emailed within 48 hours of this form's submission.
Parent/Guardian Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
Can assignments be emailed to this address?
Yes
No
What is your preferred method of communication?
*
Text
Phone Call
Email
Student Information
Student Name
*
First Name
Last Name
Preferred Name
*
Birth Date
*
-
Month
-
Day
Year
Date Picker Icon
Email Address
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Grade
Is your student neurodiverse?
Yes (Please add more information below)
No
Please expand here if there is any additional information you'd like me to have regarding your child's neurodiversity.
Are there any reasonable accommodations that will benefit your student? (Some examples may be: extra time for assignments/tests, audiobooks, a quiet fidget toy to use in class)
*
Does your student have any health / allergy concerns?
*
Has your student had issues with any of the following?
*
No Issues
Attendance
Behavior
Anxiety
Substance Abuse
Depression
Been Expelled from another program
If yes, please expand here.
Is there anything else you'd like us to know about your student?
*
Current Residence Information
Student Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best Contact Phone Number
*
-
Area Code
Phone Number
Parent / Guardian Address (IF DIFFERENT FROM ABOVE)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Emergency Contact 1
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
Relationship to Student
*
Emergency Contact 2
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Relationship to Student
Email
example@example.com
Physician and Medical Information
Primary Physician
*
First Name
Last Name
Name of Practice
*
Phone Number
*
-
Area Code
Phone Number
Preferred Hospital
Insurance/Health Coverage (Company)
*
Please list any of the following: Current medications, Medication allergies, Food allergies, Chronic health concerns.
*
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Previous School
If your student has attended a public or private school, or attended courses through another homeschool program, please fill out the information below.
School Name
*
City
State
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Date Started
-
Month
-
Day
Year
Date Picker Icon
Date Ended
-
Month
-
Day
Year
Date Picker Icon
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Course(s)
Please select which course(s) in which you'd like to register your student for the 2025-2026 year.
Course Schedule:
English I - Wednesday, 8:00 - 8:45am English II - Tuesday, 8:00 - 9:45am English III - Tuesday, 10:00 - 11:45am Speech & Debate - Wednesday, 8:00 - 9:45am Fiction Forge - Wednesday, 10:00 - 11:45am
Available Courses
*
English 1 (9th grade)
English 2 (10th grade)
English 3 (11th grade)
Speech & Debate (Elective - open to 10-12)
Fiction Forge (Elective)
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Submit
Thanks so much for registering! You will be redirected to the payment page after you hit "submit." Within the next two business days, you'll also receive an email from hello@tanglehouselearning with additional forms for signature, as well as the TangleHouse Learning, LLC handbook, and academic year calendar. *Please note that registration is not complete until payment and the additional forms are completed and received.
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