2024-2025
Program
Registration

Please complete the information below to enroll in our hybrid homeschool program.

Enrollment Application

Primary Contact First Name

Primary Contact Last Name

Phone

Family Role

Street Address

City

Postal / Zip code

Additional Contact Parent/Guardian First Name

Additional Contact Parent/Guardian Last Name

Phone

Family Role

Please describe your family's religious beliefs and affiliation.

Do you regularly attend a local church? *

Yes

Church name

For each child being enrolled, please list the following: NAME, DATE of BIRTH, AGE, GENDER, and GRADE LEVEL

Select the program option: *

Full-time

Part-time

Children Split (FT & PT)

If PART-TIME is selected: Please list the days requested for each child.

Please describe your child's interests and dislikes.

How do you hope for your child to grow through their time at Grace Family Learning Center.

Briefly describe your approach to parenting and discipline.

Describe any medical, behavioral, or other special coditions related to your child.

List any known allergies.

List any medications that your child takes.

Emergency Contact First Name

Emergency Contact Last Name

Phone

Are there any custodial or other legal agreements involving the enrolling students? *

Yes

Are you requesting financial assistance? (Only the FULL-TIME option is eligible.

Yes

I agree to the terms & conditionsView Policies and Waivers

Your Signature

Thanks for applying to volunteer with us! We'll get back to you soon.

Grace Family

Learning Center

PO Box 1651

Clayton, NC 27528

info@gracefamilylearningcenter.org

919-200-0465

Links

About

T erms and Conditions

Contact

bottom of page

2024-2025 Program Registration

Enrollment Application

2024-2025
Program
Registration