Please Print Out This Form and Follow Instructions Below.
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APPLICATION FOR INDIVIDUAL
SUBSCRIPTION NATIONAL HOME EDUCATION LEGAL DEFENSE, LLC |
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Name: |
__________________________________________________ |
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Date: |
_______________________________ |
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Name(s) of Child(ren): |
__________________________________________________ |
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Street Address: |
__________________________________________________ |
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City: |
__________________________________________________ |
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State: |
____________ |
Zip Code: |
____________________ |
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Home phone: |
(_________) ___________________________ |
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Business/Other phone: |
(_________) ___________________________ |
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Fax: |
(_________)
___________________________ |
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Email Address: |
__________________________________________________ |
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Length of time your family has been homeschooling: |
__________________________ |
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Optional for future use (as needed): |
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Public school district: |
__________________________________________ |
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Name of Superintendent: |
__________________________________________ |
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Address / Telephone: |
__________________________________________ |
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Have you saved previous correspondence
with the public school district? |
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Fee due: |
$50.00 |
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Please enclose a check payable to National Home Education Legal Defense and send to: NHELD,
LLC, (860) 354-3590 email: info@nheld.com Subscription is valid for one year. Subscription fee is $50.00 per year per family. Family is defined as mother, father, and their minor children. Single individuals also may participate in chapters to support the purposes and mission of NHELD. |
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