Co-op Inquiry Form

Co-op Inquiry Form

Get personalized answers in 30 seconds!

IS HCHC RIGHT FOR ME?
Which campus would you like to attend?*

Wednesdays at Frederick CampusTues/Thurs at Columbia CampusMondays for Live Online Instruction
What is your top priority when choosing a homeschool co-op for your child(ren)? *
Which topic concerns you the most? *
What grade level(s) are you interested in? *
What school year are you considering for enrollment?*
Would you like a copy of our School Policies sent to your inbox?*

PARENT INFORMATION
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code

STUDENT INFORMATION
Child's Full Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Child's Gender*
Does your child have any diagnosed disabilities or special needs?*

NoneSpeech or Language ImpairmentAutism Spectrum DisorderLearning DisabilityPhysical DisabilityDown SyndromeADD, ADHDOther
Do you have any additional questions? (optional)

ACKNOWLEDGEMENTS
Parent/Guardian Signature*

Powered by Jotform SignClear
Should be Empty: