SHIELD Membership Application 2020 - 2021
Family Information
First Name
Last Name
Email
Mobile Phone
Relationship
Primary Contact
*
*
*
*
--Select--
Mom
Dad
Grandparent
Other
Additional Contact 1
--Select--
Mom
Dad
Grandparent
Other
Additional Contact 2
--Select--
Mom
Dad
Grandparent
Other
Contact Information
Street Address 1*
Primary Phone*
Street Address 2
Primary Email*
City*
Confirm Primary Email*
State*
Secondary Email
Zip Code*
Church
Please select one*:
Returning Member
New Member
* - Required Fields
Student/Child Information
Please add all school-age children living at home
First Name*
Grade*
--Select--
Age 3 or under
K4
K5
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Graduated
Last Name*
Method of Schooling*
--
Home School
Not yet schooling
Other
Gender*
Male
Female
Name as it should appear in Yearbook*
Action
First Name
Last Name
Grade
School
Option
Option Group
The above information will be included in our SHIELD directory. This list is given only to SHIELD members and we ask that it not be shared. Please indicate your preference below.
SHIELD Directory*
--Select--
Yes, include our family information in the SHIELD Directory
No, exclude our family information from the SHIELD Directory
Legal Acknowledgement
I understand that SHIELD is a local homeschool support group and does NOT fulfill the legal requirements for homeschooling in SC. I also understand that SHIELD is for families homeschooling according to SC law (S.C. Code § 59-65-40(A) / § 59-65-45 / § 59-65-47). Virtual Charter Schools do not fall under this homeschool law and are therefore not eligible for SHIELD membership.
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