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Homeschool Survey Registration

The following survey results will be compiled for a Resource Guide for African-American Homeschoolers.

Please complete this 2 page survey if you have in the past, are now or will in the future, be homeschooling an African-American child.

In completing this survey, you grant permission to the author to publish your responses. Personal information such as mailing and email addresses will remain confidential. If you would like to remain anonymous, please check the appropriate box.

First Name
Last Name
Address 1
Address 2
City
State
Zip
If you prefer to remain anonymous, please check here
If you are available to answer more questions by phone, please include your phone number.
Email Address
Marital Status



Age
Which of the following best describes you?





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