A. Member Information (please print)
Last Name:
Head of Household:
Spouse:
Phone (Mr.):
(Check one: Home or Cell)
HomeCell
Phone (Mrs./Ms.):
Street Address:
City:
Zip Code:
E-mail Address:
How many years have you home schooled?
Name of church you attend (optional):
Please list information for ALL children in your home. Put an asterisk (*) by the name of any child not being homeschooled.
Name
Home schooled?
Date of Birth
Age
Grade
Gender
B. Accountability/Supervisory Association:
NOTE:YouMUST COMPLETE a separate application for your accountability/supervisory association. Completing this HERALD 5 Support Group application does NOT provide membership for ANY accountability/supervisory associations. In order to homeschool legally within the state of South Carolina, youMUST be a member of an accountability/supervisory association and not just the HERALD 5 Support Group. Examples include but are not limited to SAFE in HERALD 5 or SCAIHS. If you do not understand the difference between HERALD 5 and an accountability group, please contact us at heraldfive@gmail.com before completing this application.
Your accountability/supervisory association:
C. Membership Policy Agreement: Please sign here to indicate you intend to meet membership expectations as noted in Section C of the information page.
Signature
Please use the mouse to sign inside the box
[signature signature]
Date (please write the date in the indicated format)
D. Statement of Faith Agreement: (Note: This signature is optional, however, HERALD5 leadership positions are reserved for those who agree with, adhere to, and sign the Statement of Faith as explained in Section G of the information page.)
I,
, do agree with the HERALD5 Statement of Faith as noted in Section G of the information page.
[signature signature2]
E. HERALD5 Membership Options and Fees:
$30.00 HERALD5 New Membership
New members do NOT pay a late fee.
Total due $30
Your application is NOT COMPLETE UNTIL successful payment is received by HERALD 5. Once you click the send button below, you will receive a copy of your application via email and you will be redirected to PayPal to make your payment. If your payment does not process using PayPal through the online application, please contact the Herald5 Treasurer at Herald5Treasurer@gmail.com to make arrangements to complete your payment. If you do not wish to use Paypal, click the send button below to submit your application, but then exit out of PayPal. Mail your check to HERALD5 P.O. Box 1743 Irmo, SC 29063.
