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Request Information
1. What county are you in?
2. How many school age children do you have in the home that attend:
  Pre-School Elementary Middle High
Public
Private
Home
3. How satisfied are you with the current education that your child receives?
Very satisfied
Satisfied
Not satisfied
4. Might you be interested in sending your child to a Charter School in your area?
Yes
Possibly; tell me more
No
5. Would you be interested in serving on the advisory board for the elementary school?
Yes
Possibly
No
6. Would you be interested in serving on the advisory board for the middle school?
Yes
Possibly
No
7. Would you like information mailed to you? yes no
8. Please provide us with some information about you. (required fields are in red)
First Name
Last Name M.I.
Street Address 1
Street Address 2
City State
Zipcode
Phone
Email
Comments/Questions
 
   
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