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Course Request Form - Home School
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* Indicates required question
Name of Student:
*
Your answer
Student's Email:
*
Your answer
Parent/Guardian's Name:
*
Your answer
Parent/Guardian's Email:
*
Your answer
Parent's Phone Number:
*
Your answer
School Grade as of September, 2020:
*
Your answer
Last school attended:
Your answer
I am interested in registering for:
*
Choose
Individual year-long course
Multiple year-long courses
Bonim B'Yachad's high school diploma program
Short-Term academic support/tutoring
Please provide the specific names for each course. You can refer to the Bonim B'Yachad course catalog (
https://www.bonimbyachad.org/coursecatalog
)
*
Your answer
Do you have a curriculum and text for this course, or do you want Bonim B'Yachad to supply the learning materials?
*
I have the curriculum
I want Bonim B'Yachad to supply the materials
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