Enrollment Form

Thank you for your interest in our home schooling program.

In order to provide the highest quality education in an environment that is conducive to learning, each potential student is individually interviewed by the director. If you would like to set up an appointment with the director, please complete the brief form below, and Mrs. Preuss will contact you as soon as possible.

Thank you.

( * ) Indicates Required Field

Your e-mail address is optional but recommended so that you can receive a copy of this form with a confirmation letter via your e-mail address.

Contact Information
Parent or Guardian		*
e-Mail address
Address		*
City		*
State		*
Zip Code		*
Home Phone		*
Work Phone
Ok to call at work?
Cell or Pager
Other Contact Number
About the Student(s)
First child		*
Grade Level		* (Grades 9 - 12)

Second Child
Grade Level		(Grades 9 - 12)

Third Child
Grade Level		(Grades 9 - 12)
Other Important Facts
Special Information or needs
Other Comments
Privacy Statement
The information provided within this enrollment form is used for establishing eligibility and contact information only. Your personal information is not used for any other purposes and it is not sold. By pressing submit, you understand our privacy statement and are requesting to be contacted regarding your child's enrollment.

Receive my instruction, and not silver; and knowledge rather than choice gold. For wisdom is better than rubies; and all the things that may be desired are not to be compared to it.

Proverbs 8:10-11