Family Membership Registration Form

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Parent/Guardian full names:

Street Address:

City: State/Zip:

Phone: School District:

Occupation of Parents/Guardians:

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Names of children in the family (Please include all children, even those not in a home educational program. Please star (*) the ones who are being home schooled (“HS?”).)

NAME GRADE HS?

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Other information that you would like to share, which you feel might be of help to better serve your family:

How did you learn of BCEI?:

BCEI is non-profit and no one receives any payment for their time and efforts. It is only with all of us working together that we can make our group run smoothly. There are many jobs to fill each year and each member has a God-given talent. Please indicate any area in which you, your children or your teenagers might be interested in helping with.

E-mail Address: