WHPA Hardship Assistance for Membership Request

Status

Sponsorship Number

YearWHPANumber (e.g. 2021WHPA01) -- 10 available per year OR YearSPNumber (e.g. 2021SP01) -- number available varies (Membership Coordinator tracks this)

WHPA correspondence check complete

WHPA membership check complete

Google search complete

CCAP search complete

Notes

e.g. "7/1/2021 - Notes and comments - Michelle" Do not delete previous notes!

Your Homeschooling Status:

I am a currently homeschooling parent/guardian and correctly file the PI-1206 Homeschool Report each year I am a parent/guardian planning to homeschool I am a parent/guardian considering homeschooling None of the above

I am unable to pay WHPA's annual membership fee of $35 at this time.*

Yes No

I understand that a WHPA Hardship Assistance for Membership is:

Subject to WHPA Board approval Good for one year of WHPA membership Paid for by WHPA members and donors Not transferable or refundable

Name*

First Name

Last Name

Email*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Any additional comments?