Class Registration Form

2025 Registration Form - Enrollment Opens February 1, 2025

To register please complete the following form or email Mrs. Perkins at myhomeschoolmathclass@gmail.com

* Indicates required field

Student Name *

First

Last

Student Email *

Grade for 2024-2025 School Year *

Parent Name *

First

Last

Student Date of Birth *

Parent Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Will you be using a charter/cover school for tuition payment? If so please give name in comment secction. *

No Yes

Referred by: *

Additional Comments or Questions *

Submit