Application form

THEN – The Home Educators’ Network
Subscription / Renewal Form [circle one]

Membership renewals ($20) are due January 31 each year.
$20 paid in [ ] cash [ ] cheque :  [ ] receipt req’d     *Date: ..

Name:

Spouse’s Name:

Address:

City:

Phone:                                                             Mobile:

Email:

Child/ren’s Name 

1

2

3

4

BirthDate     HS’ed?

* Receive Newsletter by: [ ] mail/paper, or  [ ] e-mail (Adobe .pdf)

* Are you interested in attending …?
[ ] Swimsafe [ ] Family Fridays [ ] Subject Fairs eg Science Fair

* Would you like your names to be on a members’ directory? Yes / No

* Are you using a curriculum? Yes / No  If yes, which curriculum?
* Are you willing to be contacted by other home educators to discuss this curriculum? Yes /No
*

I’d like to help with/ as /on (tick)
[ ] Committee, [ ] Newsletter article, [ ] Newsletter Term Editor, [ ] Activities

* I heard about THEN from:
[ ] website [ ] THEN-Waikato e-group [ ] friends [ ] advert [ ] CAB [ ] other …

* Anything else? Any questions or comments?  

* Please join news/discussion e-group at: http://groups.yahoo.com/group/THEN-Waikato/join
Please send completed form with cheque to :
THEN Subs, P O Box 20-257, Te Rapa, Hamilton.

return to THEN-Waikato e-group HOME

Leave a Comment