Contact Us Form

S.A.L.T. CO-OP Application

If you are interested in being a member of the S.A.L.T. CO-OP, please fill out an application below. A board member will contact you to schedule an interview.

* indicates required fields

*Parent's Name::

*Street Address:

*City/ State/ Zip::

*Email Address::

*Home Phone::

Cell Phone (optional):

*How long have you been homeschooling?:

*1. Child's Name-DOB-Grade Level for upcoming year:

2. Child's Name-DOB-Grade Level for upcoming year:

3. Child's Name-DOB-Grade Level for upcoming year:

4. Child's Name-DOB-Grade Level for upcoming year:

5. Child's Name-DOB-Grade Level for upcoming year:

*Are you a member of HERF?:

YES
NO

*Are you a member of HSLDA?:

YES
NO

Please click on the SUBMIT button to submit the application.

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