chooselife EDU Co-Op Re-Enrollment Application 2026/2027

RE-ENROLLMENT FORM
By submitting this form, you and your child confirm your intent to return to chooselife EDU Co-Op for the upcoming school year. chooselife EDU Co-Op reserves the right to accept or deny re-enrollment.
Date:

MonthDayYear
Date
CHILD & FAMILY INFORMATION
CHILD'S INFORMATION *(Update only if changes are needed)
Child's Name:

First NameMiddle InitialLast Name
Preferred Name:
Age:
Date of Birth:

MonthDayYear
Date
MaleFemale
Current Grade Level:
T-Shirt Size (be specific):
Child's Address:
YesNo
Number of services attended per month:
HEALTH INFORMATION *(Update only if changes are needed)
Allergies:
Medications:
YesNo
If yes, explain:
YesNo
If yes, explain:
Physician's Name:
Address:
Phone:
Format: (000) 000-0000.
Hospital:
Address:
Phone:
Format: (000) 000-0000.

TUITION / PAYMENT INFORMATION:
Hours: M-F 8:30 am - 3:30 pm
Tuition Payment Schedule:
- Payments will be automatically deducted on the 1st of every month. Credit card must be on file, if payment is declined a $35.00 fee will be added each time declined. If payment is late an additional $35.00 fee will be added. Non-payment will result in dismissal.
- Tuition rates and payment details will be provided upon acceptance and reviewed during the enrollment meeting.
ACKNOWLEDGMENT
I confirm that all information above is accurate or has been updated as needed. I understand and agree to the expectations of chooselife EDU Co-Op, including attendance, behavior, and academic requirements outlined in the handbook.
Mother/Guardian
Date
Father/Guardian
Date
Thank You!
$50 NON-REFUNDABLE (CASH ONLY) APPLICATION FEE REQUIRED!
Re-enrollment will be processed once all fees are received. Placement is first-come, first-served.
Acceptance is finalized upon review..
Should be Empty:

RE-ENROLLMENT FORM