Member Application

Thank you for joining NCHEA. Please complete the form below or use the printable membership form.

Name
Mother _____________ Father ______________

Address __________________City ________________ State ___

Phone ___________________ E-mail ___________________________

__ Yes, I have read the NCHEA Statement of Position and agree with it.

Legislative District (click here to look up state and national districts)
State _________________ National ___________________

HSLDA Membership # ______________ HSLDA Exp. Date _________

Payment information:
___ Check ____VISA _____ Master Card
Credit card #_________________ CVS # _______________
Name on Card __________________ Expiration Date __________

Membership Fee $24
Gift Amount ___
Total ___

Train up a child in the way he should go, even when he is old he will not depart from it. Proverbs 22:6