Homeschool Support Group Information Group Name* Private InformationThe information you enter in this section will not be publicized.Contact Name First Last Group Leader Name* First Last Group Leader Email* Group Leader PhoneIs your group open to new members?* Yes No How is your group best described?* Support group Co-op Facebook or Yahoo Group How many families are members of your group?*Please enter a number from 10 to 1000.Is you co-op a ministry of a particular church'?* Yes No What is the name of the church* What is the address of the church* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please list the activities and resources your group offers Regular meetings for parents Parents night out events Field trips Co-ops or education resource center Sports Band or orchestra Homeschool prom Graduation ceremony Learn about homeschooling event Is at least one parent of all students present while you are meeting?* Yes, at least one parent is present. No, not all students have a parent present. Does your organization have students from three or more families who are age twelve and younger* Yes No How many days a week does your organization meet?* More than two days One or two days How many hours do you meet in a day?* More than four hours Four hours or less Is your organization a NC licensed child care center?* Yes No Do you wish to have your organization listed on the NCHE website? Yes, please list our group. No, don't list our group. Public InformationEnter information you want NCHE to publicize.Is your group a secular group?* Yes No How is your group best described?* Support Group Co-op Facebook or Yahoo group Contact Email Contact PhoneGroup Website Ages Served* Area Served*Enter the zip codes, cities, counties or regions your group serves.Group Description*Enter a brief description of your group and activities in 300 characters or less. Spaces count as characters.
