Membership Application Please read this first!IMPORTANT: Your membership letter will be generated from the information you enter - your name, address, school district, start date, and student names. If you enter information incorrectly, your membership letter will have errors. If I catch the errors before confirming your application, I'll void it out and you can resubmit it. If I don't catch them, you'll need to submit a correction form. NOTE: I won't offer membership cards beginning with the 2021-2022 school year - only membership letters.Parent/Guardian (primary instructor):* First Last Email address of primary instructor:* Enter Email Confirm Email Phone*If this is a cell phone, you may receive infrequent texts about important deadlines, events you're registered for, and upcoming field trips. You can opt out at any time.Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Which school district (not county) do you reside in?*See this directory for a list. Call your local school to verify if you're not certain.AbbevilleAikenAllendaleAnderson 1Anderson 2Anderson 3Anderson 4Anderson 5Bamberg 1Bamberg 2Barnwell 19Barnwell 29Barnwell 45BeaufortBerkeleyCalhounCharlestonCherokeeChesterChesterfieldClarendon 1Clarendon 2Clarendon 3ColletonDarlingtonDillon 3Dillon 4Dorchester 2Dorchester 4EdgefieldFairfieldFlorence 1Florence 2Florence 3Florence 4Florence 5GeorgetownGreenvilleGreenwood 50Greenwood 51Greenwood 52Hampton 1Hampton 2HorryJasperKershawLancasterLaurens 55Laurens 56LeeLexington 1Lexington 2Lexington 3Lexington 4Lexington/Richland 5MarionMarlboroMcCormickNewberryOconeeOrangeburg 3Orangeburg 4Orangeburg 5PickensRichland 1Richland 2SaludaSpartanburg 1Spartanburg 2Spartanburg 3Spartanburg 4Spartanburg 5Spartanburg 6Spartanburg 7SumterUnionWilliamsburgYork 1York 2York 3York 4Start Date (must be JUNE 1, 2021 or later)* MM slash DD slash YYYY IMPORTANT: This is the date you will begin homeschooling. It MUST BE June 1, 2021 or later. This is the enrollment date on your membership letter and can't be changed. NOTE: Children learn 365 days a year, but SC homeschoolers must document 180 of those days. You can count half-days, weekends, summer visits to a museum or historic site, art and music lessons, etc. Learning happens all the time, and all of it counts. If you transfer mid-year from a public or private school, your student's attendance there counts as part of the 180-day total. Your start date must be June 1, 2021 or later. Membership runs from June 1, 2021 to May 31, 2022.Student InformationList each student's name, birthdate, and grade level for the UPCOMING year (2021-2022) below. Students must be at least 5 years old before September 1, 2021 to be registered with Carolina Homeschooler. If your student will get a beginner's permit or driver's license this year, please include full legal name (including middle name). The DMV will need this due to REAL ID requirements.Student 1 Name (First Middle Last)* Student 1 Birthdate* MM slash DD slash YYYY Student 1 Grade Level* Student 2 Name (First Middle Last) Student 2 Birthdate MM slash DD slash YYYY Student 2 Grade Level Student 3 Name (First Middle Last) Student 3 Birthdate MM slash DD slash YYYY Student 3 Grade Level Student 4 Name (First Middle Last) Student 4 Birthdate MM slash DD slash YYYY Student 4 Grade Level Student 5 Name (First Middle Last) Student 5 Birthdate MM slash DD slash YYYY Student 5 Grade Level Student 6 Name (First Middle Last) Student 6 Birthdate MM slash DD slash YYYY Student 6 Grade Level More students?Have more students? The more, the merrier! Just list their names (First Middle Last), birthdates, and grade levels here, and I'll add them to my roster manually.Required Legal InformationPlease complete all required fields below.For the school year beginning June 2021 or later, have you registered with (or plan to register with) another SC Option 2 or Option 3 homeschool association (other than Carolina Homeschooler), and/or a SC public school, a public virtual charter school (like SCVCS, K12, Connections Academy, Calvert, etc.), and/or a private school?* Yes No What is the name of the SC Option 2 or 3 homeschool association (other than Carolina Homeschooler), state-sponsored virtual charter school, or private school you are (or will be) registered with for the UPCOMING (2021-2022) school year?* Primary Instructor's Education Level*SC state law requires the primary instructor to have completed high school or have a GED certificate. General Education Development (GED) Certificate Completed High School Completed College (Associate Degree or higher) Parent or Legal Guardian?*Is the primary instructor the parent or legal guardian of all students listed in this application? If "no," please email firstname.lastname@example.org within 24 hours after submitting this application to explain your circumstances. Yes No Same Household?*Do all the students listed in this application live in the same house? If "no," please email email@example.com within 24 hours after submitting this application to explain your circumstances. Yes No Outside Agency Involvement?*If you've had any contact with the Department of Social Services, Department of Juvenile Justice, or other state or local agencies, please describe the circumstances below. (Type "none" if you've had no contact.)Special Needs?Please describe any special educational needs of your student(s).The primary instructor agrees to the following five requirements mandated by Section 59-65-47 of the SC Code of Laws:*Please check the box in the section below to confirm you've read, understand, and agree with all five items. 1. Document at least 180 days of attendance from June 1, 2021 to May 31, 2022. 2. Provide instruction in the areas of reading/literature, writing/composition, mathematics, science, and social studies. 3. Maintain a plan book, diary, or other record of instruction and activities for each student. 4. Keep a portfolio of samples of each student's academic work. 5. Maintain semiannual progress reports documenting attendance and student progress in each required academic area. Please check the box in the section below to confirm you've read, understand, and agree with each item. (The checkbox may be a tiny box in the middle of the column, depending on your device.)* 1. Section 59-65-47 mandates that parents/guardians maintain the required academic records. However, I understand Carolina Homeschooler reserves the right to request copies of my records if an audit is required by any state agency. I will mail my records to Carolina Homeschooler within three days of receiving a request for records. 2. I understand Carolina Homeschooler does not provide transcripts or high school/college guidance for member students. 3. I understand Carolina Homeschooler communicates to members via email for time management and record-keeping purposes, and usually replies to emails within 24 hours. 4. I will inform Carolina Homeschooler of any changes in my contact information (email, phone, and address), and homeschool status during the school year. 5. I will inform Carolina Homeschooler by email within 24 hours if I am contacted by any state or local agency about my homeschool. 6. My membership begins on June 1, 2021 and ends on May 31, 2022. I will submit an end-of-year completion form by June 5, 2022 certifying I've met all legal requirements for the 2021-2022 school year. 7. Carolina Homeschooler reserves the right to revoke membership of families who do not adhere to stated requirements and/or the mandates of Section 59-65-47 of the SC Code of Laws. 8. Membership fees are not refundable for any reason. Payment InformationYou're almost finished... just a few more things left to do!Membership Fees* 1 Student - $75 2 Students - $100 3 Students - $125 4 Students or more - $150 Total due:Your credit/debit card will be charged when you click the button to submit this form. $0.00 Credit Card*Payment is due upon submission. Your payment will be voided/returned if your application is not accepted.Card Details Cardholder Name Signature of Primary Instructor:*Submit Application:* By electronically signing and submitting this application, I acknowledge I've reviewed my application and the information I've provided is accurate and complete. I agree to the terms described above and am ready to submit my application. CommentsThis field is for validation purposes and should be left unchanged.