CALIFORNIA HOME EDUCATORS
Home school legal defense membership application - Annual Fee - $25

Father's Name:
Relationship to student: (Biological, step, etc)
Education: (Highest grade completed):

Mother's Name:
Relationship to student: (Biological, step, etc)
Education: (Highest grade completed):

Address:
City,State,Zip:
Phone:

E-mail Address:

1. How long have you been home schooling?
2. Have you ever been investigated for or charged with child abuse or neglect or any other related charges? (Yes or no) If yes, please explain fully on a separate sheet of paper and include copies of the court documents.

3. List School Age Children (living in your home):
Name, grade, disability?


4. Please indicate home school method
Teaching Credential., ISP (Private School Enrollment)
Name of School:
Address:
City, St, Zip:
Administrator:
Phone Number:

5. The information provided is true, complete and accurate to the best of our knowledge. We will comply by CHE's Legal Defense Membership Agreement.

Membership Agreement: Each family member agrees to:
A. Exercise diligence in responsibly teaching our children.
B. Use curriculum and a formal or informal program of education.
C. Keep minimal records (Course of Study, faculty information,
and attendance record).
D. Notify CHELD of any negative contacts.
E. Cooperate fully in the defense of any legal action.
F. Pay all reasonable costs, other than attorney's fees in defense
of any legal action.

Father I agree to the above policies Date:
Mother I agree to the above policies Date:

ANNUAL MEMBERSHIP FEE of $25.00 (Non Refundable) will be billed upon receipt of this application.

NOTE: The fund will not defend a member in a civil custody case between divorced parents involving an issue of home schooling. The Fund reserves the right to refuse any application. If any of the information you have provided is false or deliberately misleading, this agreement is null and void. The Fund reserves the right to underwrite or approve an appeal.

Complete this form and submit or print completed page and then mail or fax to:

California Home Educators
13216 Leach St.
Sylmar, CA 91342
(818) 523-6791, (818) 362-1489 fax