Chosen Co-op

New Family Application

For information on tuition or if you have any questions about the application, give us a call at (541) 525-0776.

Student Information

Please include all children applying for the homeschool co-op. We accept children from Kindergarten to 8th Grade.

Student 1

First Name

Last Name

Birthday

Gender

Grade for 2024-25 School Year

Interests or Hobbies

Do you have any special information or needs that may be helpful for us to know about you or your children?

For example: severe allergies, special needs, etc.

Parent / Guardian Information

First Name

Last Name

Relationship to Student

Phone Number

Email Address

Communication Preferences

Address

Where the student(s) live; Include apartment number, suite number, etc.

City

State

Zip Code

Emergency Contact Information

First Name

Last Name

Relationship to Student

Phone Number