Christian Homeschooler's Association of South Eastern South Carolina
PO Box 58
Ruffin, SC 29475
Applications are currently being accepted and processed; however your accountability with us will be for the 2003‑2004 school year. We are not accepting members for the 2002‑2003 school year. You will need to submit all year‑end forms required to your previous association or school district for the 2002‑2003 school year. CHASE SC accepts applications all year long.
CHASE SC Lifetime Membership Enrollment Application
2003 to 2004
Parents or Legal Guardians
Primary Teacher: _______________________________________________
Last, First Name MI
*_____GED _____High School Diploma
Secondary Teacher: _______________________________________________
Last, First Name MI
_____GED _____High School Diploma
* A copy of the primary teacherís GED or High School Diploma must a) be submitted with your application and b) be kept at home on file with your school records.
City, State Zip
Phone ( ______ )_________________________
** All members are required to have their own email address and to be on the CHASE‑SC Newsletter Group as long as they are members. This is a newsletter style email based loop, and CHASE SC will utilize this cost effective newsletter format to share updates and reminders with you. It is your responsibility to notify us immediately your new email address whenever your email address changes.
_________________________________________Mailing address if different
_______________________________________________City, State and Zip
Public school district in which your home is located
(see the listing available at the Forms site page):
List ALL children in K‑5 to 12th grade that will be homeschooled as members of CHASE SC
for the 2003‑2004 school year.
Children's Name Grade K‑5 to 12th
1) Have you been contacted by any official in the past year regarding your home school? This would include school district personnel, truant officers, Department of Social Services, or any other official who contacted you for information concerning your children's education.
If yes, please provide an explanation here.
2) ***Are there any students in your homeschool who are not your children?
Which children? What is their relationship to you?
***You must provide a copy of a court order showing proof of guardianship in order to homeschool any child/ren that are not yours. For foster children you must provide a letter from the local or state DSS, or the agency that has custody stating that you may homeschool them.
3) How many years have you homeschooled?
________ Do not count the 2003-2004 school year.
CHASE SC only accepts homeschoolers that have homeschooled a minimum of two complete school years.
Beginning Date of Home Schooling in SC:_________________ (Anytime on or after July 1st)
Ending Date:__________________ (School year must end by June 30th)
State law requires that the instructional year be a least 180 days.
CHASE SC members have the freedom to set up their school year in any manner they please, because the school year does not need to conform to the traditional school schedule of August‑May. For instance, if you wanted to school year round you could school 5 days a week for 3 weeks and take every fourth week off. This year round plan would still leave you with 4 extra weeks for Christmas and/or vacations. However to help maintain our records and close out files at the end of an instructional year, members must plan to complete at least 180 days of instruction by June 30th. (The ending date of your school year needs to be on or before June 30th.)
Homeschoolers moving to SC from out‑of‑state, year round homescoolers, those with a personal crisis, or family emergencies may receive an extension on a case by case basis.
Policies of CHASE SC:
A. I/We hold at least a high school diploma or the equivalent general educational development (GED) certificate, have included a copy of it for the primary teacher-parent and will maintain a copy with our school records.
B. I/We agree to submit the Year End Statement of Completion/Update on or before July 31st each year that we homeschool during our Lifetime membership.
C. I/We will include in our curriculum (provided by me/us) at the minimum; the basic instructional areas of reading, writing, mathematics, science, and social studies, and in grades seven through twelve, composition and literature.
D. I/We will maintain the following educational records:
(1) a plan book, diary, or other record indicating subjects taught and activities in which the students and parent‑teacher engage;
(2) a portfolio of samples of the student's academic work; and
(3) a semiannual progress report including attendance records and individualized documentation of the student's academic progress in each of the basic instructional areas specified in item # C above.
E. I/We certify all of the information on this enrollment application form is complete and accurate to the best of my/our knowledge. If any information above is found to be false my/our membership may be terminated or I/We may be placed on probationary status.
F. I/We understand that CHASE SC may require a complete review of the student records if such verification is needed for the local authorities, and I/we will provide to CHASE SC within 24 hours of being requested any copies needed for the verification.
G. I/We understand that the $35 Lifetime Family Membership dues are non‑refundable upon acceptance. I/We also understand that applications denied will be assessed a $10 processing fee and a refund for $25 will be returned to me/us.
H. I/We understand there is a $25 fee on all returned checks. Returned checks not reimbursed (along with the $25 returned fee charge) within 30 days will result in termination of Lifetime Family Membership.
I. I/We understand that CHASE SC will provide membership verification to officials when needed or when requested by me/us.
J. I/We understand that within 10‑30 days of approval we will receive a membership packet with our certificate of membership and membership cards. I/We understand that if we have not received the membership packet within 30 days that I/We need to contact CHASE SC by email to verify that CHASE SC has received my/our application.
K. I/We understand that failure to comply with any of CHASE SC's policies may result in our homeschool being placed on probationary status or termination of our Lifetime Membership.
L. I/We understand that by submitting this application to CHASE SC that I/we are required and do hereby agree for CHASE SC to place our own personal email address as a member on the CHASE‑SC Newsletter Group, where all updates and reminders will be posted for us. Additionally, it is our responsibility to maintain and monitor my/our email address and to keep CHASE SC informed of any email address changes.
M. I/We understand that after completing this application I/we should make a copy of this application for our records.
______________________________Father's signature ____________________Date
______________________________Mother's signature ____________________Date
CHASE SC reserves the right to refuse or deny enrollment to any applicant.
Applications cannot be process unless all questions are answered, the appropriate payment is enclosed, and both parents/legal guardians have signed this form (single parents should write N/A on the unused blanks).
Please make sure that you have:
a) attached a copy of the primary teaching parent's GED or High School Diploma,
b) verified that all questions are answered and that signatures are in ALL appropriate places,
c) that you have included your own email address and printed it clearly,
d) and that you've enclosed a check or money order for $35.00 made payable to CHASE SC.
For Office Use:
Check or Money Order Number_________________________
Membership Approved & M P Mailed ____________________