Ages 3–12

Thank you for your interest in joining our homeschool co-op and early-education learning program! We are a collaborative learning community that values partnership between families, a nurturing learning environment, and multi-sensory, developmentally appropriate education. Both programs offer a small group environment with a certified teacher with advanced training and education in their area of expertise.

Our early learning program will run Monday and Wednesday from 9-11. This program will focus on pre-academic skills: play based learning, social and emotional regulation, and a multi-sensory approach to skills for optimal learning and engagement.

Our homeschool co-op program will focus on reading and math skills in an evidence-based curriculum. This program will also include movement and a variety of learning tools to meet learners where they are at and engage the body and mind for optimal learning.

Please complete one application per child.

Which program are you interested in:

Child Information

First Name *

Last Name *

Preferred Name/Nickname:

Date of birth *

Grade-Level Equivalent (if applicable):

Has your child previously participated in a homeschool co-op?

If yes, please describe the experience:

👨‍👩‍👧‍👦 Family Information

Parent/Guardian #1 Name: *

Phone *

Email *

Address

Street Address

City

State

Country

Postal code

Preferred Method of Communication:

Parent/Guardian #2 Name (if applicable):

Phone Number:

Email Address:

Home Address:

Preferred Method of Communication:

🎯 Family Goals and Educational Philosophy

Please take a moment to share your family’s values and goals around homeschooling.

Why are you homeschooling your child? What led you to seek a co-op?

What are your top 2–3 goals for your child this year (academic, social, emotional, or otherwise)?

Describe your ideal homeschool co-op experience:

How does your family approach learning at home (e.g., structured curriculum, interest-led, classical, unschooling, etc.)?

🤝 Partnership & Participation

We are a community built on mutual support, collaboration, and trust. Please review and respond to the following statements.

Do you have any skills, resources, or interests you’d be willing to share with the group (e.g., teaching, arts & crafts, music, science, gardening, etc.)?

How do you see your role in supporting the community of learners beyond your own child?

Our co-op values consistency and clear communication. Are you able to commit to regular attendance and collaboration with both teachers and other families?

Yes

Additional Comments

🌱 Child's Strengths, Needs, and Learning Profile

What are your child’s academic strengths? (e.g., reading, math, creative thinking)

What areas of learning or development does your child find challenging?

Does your child have any diagnosed learning differences, sensory needs, or support services (OT, PT, speech, etc.) that we should be aware of to best support them?

Describe your child’s personality and social needs (e.g., shy, energetic, prefers small groups, leadership tendencies):

Does your child require any accommodations for learning, behavior, or physical access?

What helps your child thrive in group learning environments? What tends to cause stress or disengagement?

⛑️ Health & Safety

Allergies or medical concerns:

Emergency Contact Name & Phone:

✍️ Final Notes

Please use this space to share anything else you’d like us to know about your child or family:

Any files you'd like to share with us:

✅ Agreement

By submitting this application, I acknowledge that:

I understand this co-op is a shared learning community that requires family participation.
I am committed to supporting the mission and values of the group.
I will work in partnership with facilitators and fellow families to ensure a positive experience for all.

Parent/Guardian Signature: *

Clear

Date: *

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