Academy Charter School Registration
Homeschool Support Program

Parent's Name

Date:

Address:

Street:

City:

Zip:

Phone Numbers:

Home Phone:

Mobile Phone:

Email:

Emergency contact if no answer at the above numbers

Name:

Phone:

 

  

Please list all children enrolling in the homeschool program for the upcoming school year
 
First Name
Middle Name
Grade
Date of Birth
1.
2.
3.
4.
   

Registering as a part-time student at Academy Charter School for the homeschool classes conducted in:
   

Enrolled in any other publicly funded program?
   

Questions or Comments:

Please print this page for your records.

If you have not received a response from the homeschool office within five work days, please call
303-663-2374 and leave a message.

 

  
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