Request Membership Form, ASHA - 1 YearAHSA Yearly Membership Fee$60.00Please Signup* Is this an initial or renewal application for AHSA?Initial ApplicationRenewal Application * Primary Last Name * Primary Parent First Name * Primary Email Secondary Last Name Secondary First Name Secondary Email * Address * City* StateSCOther If you selected other for state, enter your state here. * Zip Code * Phone Additional Phone* Is your child/children enrolled with an Option 1, 2, or 3 according to SC Homeschooling laws?YesNo If yes, please list accountability group:* Anderson Homeschool Association (AHSA) is a Christian homeschool support group. We offer field trips, outings, volunteer opportunities, standardized testing, and access to co-ops. AHSA’s mission is to advocate for Christian home education by providing opportunities to connect with likeminded families. We do not offer 3rd Option accountability group.I acknowledge that AHSA is only a support group and NOT a 3rd Option accountability group.Child # 1 Information * Child 1 First Name * Child 1 Last Name* Child 1 Current GradeNurseryPre-KKindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th * Child 1 Current Grade* Child 1 Current Age0-11 months123456789101112131415161718Over 18 * Child 1 Current Age* Has this student been truant, suspended, or expelled from a public or private school?YesNo If you answered “Yes” to the question above, explain why hereIf you have additional children to add, please complete the next few sections. If not, you can skip ahead past them. Child # 2 Information Child 2 First Name Child 2 Last NameChild #2 Current GradeNurseryPre-KKindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th Child #2 Current GradeChild 2 Current Age0-11 months123456789101112131415161718Over 18 Child 2 Current AgeHas this student been truant, suspended, or expelled from a public or private school?YesNo If you answered “Yes” to the question above, explain why hereChild # 3 Information Child 3 First Name Child 3 Last NameChild 3 Current GradeNurseryPre-KKindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th Child 3 Current GradeChild 3 Current Age0-11 months123456789101112131415161718Over 18 Child 3 Current AgeHas this student been truant, suspended, or expelled from a public or private school?YesNo If you answered “Yes” to the question above, explain why here More than 3 children?Enter the information for each additional child outside 3 here.More Information Church Affiliation* Have you ever been a member of AHSA in the past?YesNo * How long have you been homeschooling? Why did you decide to start homeschooling? Please explain why you’ve chosen AHSA.* Are you or any other members of the home currently being investigated by Social Services?YesNo* Have you or any other members of the home been investigated by Social Services in the last 5 years?YesNo If you answered yes to either of the last two questions, please explain here.Please acknowledge that you have read and understand the AHSA Statement of Faith. Click Here To View AHSA Statement of Faith Yes, I have read and understand the AHSA Statement of Faith.Yes* I understand that all leaders and teachers in AHSA must bear testimony of belief in accordance to our Statement of Faith. All member families must subscribe to a Christian worldview and be supportive of the teachings outlined in our statement of faith. By checking the box below I acknowledge that I/we have read and agree to support the teachings outlined in the Statement of Faith.YesAHSA Hold Harmless Agreement * I understand that none of the churches or other organizations that allow AHSA to use their buildings or grounds are associated with AHSA in any way. I understand that each are allowing AHSA to use their facility and properties without rent as a gracious gesture in show of their support of AHSA and its commitment to provide children with an excellent and biblically based education.I hereby declare that neither I nor any family member will in any way bring legal action or any other obligation upon any of the churches or organizations that allow us to use their facilities, or AHSA, or any AHSA Board member for any reason pertaining to and/or involving me or my children’s activities or injuries with AHSA while on the premises of any of these facilities or on any AHSA activity or field trip.I also hereby declare that I will ensure that my children follow the code of conduct set by AHSA for field trips, co-op, or any AHSA activity. I declare that my children will behave themselves in such a way as to preserve and protect the building, properties, and possessions of all the facilities in which we meet. I will be personally responsible to replace any property my child/children damages while participating in AHSA activities at any of these facilities.By clicking the box below, I acknowledge that I/we have read and agree to the above Hold Harmless Agreement.YesI have read the AHSA Code of Conduct and By-Laws. (See website About -> Code of Conduct page.)Yes* Check EACH box below indicating that you understand each of the following:I understand I am entering into a contract with the AHSA Board, agreeing with the following statements and accepting ALL terms of this contract.I understand that AHSA is a Christian organization and that by submitting this application for membership in AHSA, I am agreeing to abide by all standards and policies of AHSA as established by the Board of Directors and will refrain from engaging in any activity which may bring reproach on this group or home education. I understand that doing so may result in my family’s membership being terminated.I understand that NO STUDENT ON PROBATION WITH THE STATE IS ELIGIBLE FOR MEMBERSHIP WITH AHSA.I understand that NO STUDENT PREVIOUSLY EXPELLED FROM A SCHOOL WILL BE ELIGIBLE FOR MEMBERSHIP WITH AHSA.I understand that my child(ren)’s photos may appear on the AHSA website or Facebook page.I understand that AHSA will NEVER give out an AHSA member’s information to parties outside of AHSA. First names may be used on the AHSA website. No names will be used on the Facebook page.* New Members: I understand that this payment does not guarantee membership. This application will be reviewed, and a membership letter of acceptance or denial will be sent to your email.I UnderstandReturning Members: If you are completing a renewal application your membership will automatically be approved and you will not receive an email. In the event the board is not renewing your membership you will receive a denial email. Create a username and password of your choice. These credentials will be used to access your account on the AHSA website once your membership request form has been submitted. * Username * PasswordStrength: Very WeakIs your child/children enrolled with an Option 1, 2, or 3 according to SC Homeschooling laws?YesNoRadio ButtonRadio1Radio2Done(Use Cropper to set image and use mouse scroller for zoom image.) Select Your Payment GatewaySquareHow you want to pay?Auto Debit PaymentManual PaymentEnter Coupon CodeEnter Coupon CodeApplyPayment SummaryYour currently selected plan : Plan Amount : Coupon Discount Amount : Final Payable Amount: Submit
