Ember & Root Homeschool Enrichment Program Application (2025-2026)
Thank you for your interest in Ember & Root! We're excited to learn more about your family and explore how our self-directed learning community might support your journey.
Parent/Guardian Information
Parent/Guardian Name(s)
*
First Name
Last Name
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Contact
*
Email
Phone Call
Text Message
What city do you live in?
Learner Information
Learner's Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Current Age
*
Gender
*
Most Current School Year Educational Setting
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Homeschool
Public School
Private School
Microschool
Other
Does your learner have any specific learning needs or accommodations?
*
Educational Philosophy & Fit
What draws you to Ember & Root's approach to learning/community?
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How do you expect your learner to respond to self-directed or interest-led learning environments?
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How long has your child been homeschooled? What has their educational experience been so far?
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Describe your learner's social and emotional learning needs:
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What are your family's main goals and values for this child (educational or otherwise)?
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What role do you hope this community will play in your child's development?
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Learner Interests & Strengths
What activities spark joy in your learner (academic or non-academic)?
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What are your learner's strengths and areas of confidence?
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Select the option you are interested in
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1 day/week Tuesdays ($165 a month)
1 day/week Thursdays ($165 a month)
2 days/week Tuesdays AND Thursdays ($285 a month)
Will you be using Class Wallet/EFA funds to pay for this program?
yes
no
Are there specific areas where your learner seeks growth or support?
*
Learner Voice: What interests you about Ember & Root?
Additional Info
How did you hear about Ember & Root?
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Word of Mouth
Facebook
Online Search
Other
Is there anything else you'd like us to know about your learner or family?
*
Submit
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