Application/Registration 2019-2020 (Tampa Bay, FL) Tell us about YourselfName* First Last Cell Phone Number*Email Address* Spouse's Name First Last Spouse's Cell Phone NumberSpouse's Email Address Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone Number (if applicable)Home Parish* Permission granted to include your contact information in a directory to be distributed to your chapter families. Permission granted to use anonymous photographs of your family members on our blog, website, or printed materials. I am interested in working in my chapter. (This may help off-set some of your tuition.) ChildrenStudentsFull NameAge student will be on Sept. 1Birth Month and YearGrade level on Sept. 1Special Needs (if any) Other ChildrenFull NameAge child will be on Sept. 1Please enter: adult, in another school, nursery, or lapSpecial Needs (if applicable) Form Submission and PaymentBy submitting this form I acknowledge and agree to the following: I understand that CSH is not a drop-off program. I understand that I will be invited to our online sharing area, Basecamp, that all material shared in Basecamp is the property of Catholic Schoolhouse, and agree to return or destroy all materials if I withdraw my membership. I understand that as a member of a Catholic Schoolhouse Chapter, I am bound to abide by the rules laid out in the Chapter Licensing Agreement. How did you hear about Catholic Schoolhouse?Web SearchConferenceInfo meetingWord of mouthLibraryChurch bulletinOtherFamily Registration Price: $70.00 Early bird discount registration $70.00 until March 15. After March 15, standard $90.00 registration fee applies. All fees non-refundable.Payment Method*Online (Credit Card or PayPal)All fees non-refundable This will be visible during open enrollment.