Homeschool research

Welcome to HomeRoots by BEL-C

We are so glad to have you here. This form helps us understand your context and how HomeRoots can best support you — now and over time.
SECTION 1 — Who This Is For
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home-based childcare providerHomeschool familyIndependent educator / tutorExploring options (not active yet)
SECTION 2 — Your Learning Context
Infants (0–18 months)Toddlers (18 months–3 years)Preschool (3–5 years)Early Elementary (Grades K–2 / approx. 5–7 years)Elementary (Grades 3–6 / approx. 8–11 years)Middle School (Grades 7–8 / approx. 12–13 years)High School (Grades 9–12 / approx. 14–18 years)Mixed ages / multi-age groupNot currently active (planning or exploring)
Number of children/learners
Location (city / neighbourhood only)
SECTION 3 — What You’re Looking For
I want better tools and structure for day-to-day planningI’m looking for ideas, shared learning, or enrichment opportunitiesI want support with a specific challenge, transition, or next stepI’m not sure yet — I’d like to talk it through
SECTION 4 — Timing
Just exploring / planning aheadIn the next few monthsI need support fairly soonSomething needs attention now
Is there anything you’d like us to keep in mind as we review your intake?
SECTION 5 — Contact & Follow-Up Preference
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
EmailText MessageShort callNo preference
SECTION 6 — Acknowledgement
I acknowledge that HomeRoots is a support hub designed by Beacons' Early Learning Collective to complement and support small childcare programs and homeschool approaches.
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Welcome to HomeRoots by BEL-C

SECTION 1 — Who This Is For

SECTION 2 — Your Learning Context

SECTION 3 — What You’re Looking For

SECTION 4 — Timing

SECTION 5 — Contact & Follow-Up Preference

SECTION 6 — Acknowledgement