Greater Glens Falls Christian Homeschoolers

GREATER GLENS FALLS CHRISTIAN HOMESCHOOLERS (chapter of LEAH)

Membership Form

___ New member ____ Former member of LEAH, not currently active in any chapter
___ Transferred membership from this chapter __________________________________
___ Dual Membership; dues paid in this chapter _________________________________

Parents' Names: _________________________________________

Address: _______________________________________________

City: ___________________________ State: _______ Zip+4: _____________________

County: _________________________ E-mail: _________________________________

Phone: __________________________ Fax: ___________________________________

HSLDA member? Yes ________ No _________ Applying Now _________

Legislative District (May be obtained from County Board of Elections or the HSLDA website)

U.S. Congress _____________________ NYS Assembly ______________________

NYS Senate _______________________ School District ______________________

Children's Names: DOB:

_________________________________ _____________________________

_________________________________ _____________________________

_________________________________ _____________________________

_________________________________ _____________________________

_________________________________ _____________________________

_________________________________ _____________________________

_________________________________ _____________________________

To view and print as a Word document, please click here: http://glensfallsleah.freeservers.com/GGFCH_membership_form.doc

When you have completed both parts of your application, please send them, along with the $25 yearly dues, to Greater Glens Falls Christian Homeschoolers, 5 Arbor Drive, Hudson Falls, NY 12839.  We will get in touch with you upon receipt.