CHEC Registration Form
Name
Parent Name
Address
City
State
Zip Code
E-mail address
telephone number
Grade Last Completed
Birth Date
School Last Attended
Date Last Attended
School Address
School Phone Number
School Fax Number
The Online program for 9th- 12th grade students will have time blocks of 6 hours, Monday through Friday. Please choose the one that best fits your families schedule.
Note: In addition students may work any time between 8 P.M. and 8 A.M. and on weekends as long as there is a slot open.
8 A.M. - 2 P.M.
2 P.M. - 8 P.M.
The Online program will be broken into shifts of 4 hours for 3rd to 8th graders, from Monday- Friday. Please choose the time that best fits your student. Times are between 8 A.M. - 8 P.M.
8 A.M. - 12 P.M.,
12 P.M.- 4 P.M.
4 P.M.- 8 P.M.
Package Choice
Online Program
Workbook Program
Kindergarten Package
Learning Center
If Kindergarten Package how would you like to pay?
One Time Payments $330 and $50 registration fee
$110 down and 9 monthly payments of $30
Please list any special needs or talents for which you would like resources.
Do you prefer to be contacted by phone or e-mail. If phone time preference.
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