Dunwoody Homeschool
2010-2011 Master Registration
Student Name:________________________________________________________
Date of Birth: ______________________ Grade: ____________________________
Parents Names: _______________________________________________________
Address: ____________________________________________________________
Email address: ________________________________________________________
Home Phone: ______________________ Cell: ______________________________
Emergency Contact: ____________________________________________________
Class Day/Time
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
In 2010 / 2011 there will be a $10 per student, per semester charge for Study Hall
which will be made payable to Becky Humphrey at the beginning of each semester.
Please circle day/days student will be staying for lunch: Wednesday Thursday
Circle which parent committee you would like to volunteer on:
Lunch Volunteer Field Trips Activities (yearbook, service, parties)
I understand that I must pay the Dunwoody Classes fees for 2010-2011 which will be
$40 per semester for one student or $60 per semester multiple students. The
membership fee is made payable to Becky Humphrey and must be paid before or
by the first day of class for each semester. The facility fee paid to North Peachtree
Baptist Church will be a separate check for $40 paid at the beginning of the first
semester for the entire school year. Teacher registrations and tuitions are made
payable separately to the individual teachers and sent directly to them.
Signature______________________________________________ Date_________
Please mail a master registration form with all classes listed on it to:
Becky Humphrey, Administrator
2678 Camelot Ct.
Duluth, Ga. 30096
Contact individual instructors about where to send registration for each class.