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Family Information

Family hobbies and areas of interest: _________________________________________________________________________________________

_________________________________________________________________________________________

How long have you been home schooling? ________ Years □ We haven’t yet. We’re just getting started.

Why are you joining/What are your expectations?_________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

What skill, knowledge, facility, etc. do you have that you would like to make available to NEPHS members?

_________________________________________________________________________________________

Would you like us to send you an application to join Home School Legal Defense Association?   □ Yes □ No

New members: How did you hear about NEPHS?  ________________________________________________

MEMBERSHIP APPLICATION

September 2008-August 2009

This information will be included in the Roster to create fellowship opportunities for families with similar interests.

□ New Member

 

□ Renewal

 

Children’s Names

(as they should appear in the Roster)

 

Birth Date

 

Sex

Last Name

 

 

 

 

 

 

 

 

 

 

 

Husband

 

Wife

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

 

Zip (9 digits, please)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home Phone No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fax No.

Fax is: □ at home  □ at work  □ call before faxing 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E-mail Address

(Required to receive e-mail Newsletter)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Church your family attends

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pastor’s Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Denomination

 

 

 

 

 

 

 

 

 

 

 

□ Our church might be available for NEPHS functions.

□ Our home might be available for NEPHS fuctions.

 

Please list additional on a separate sheet.