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Homeschool Clubs Award Request Form

By Beverly Hernandez, About.com

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Mail list with $.63 stamp to:

Beverly Hernandez
Homeschool Clubs
5815 E. La Palma Ave. #184
Anaheim, CA 92807

Student's Name___________________________________________

Address_________________________________________________

________________________________________________________

Grade Level____________

**Remember to send $.63 stamp with form**
Parent Initial__________

Which Club and Assignment?__________________________________________
(example: Writing Club - Valentines Poetry)

Title of submission:__________________________________________________
(example: "My Mom")

Date submitted:_____________________________________________________
(Date submitted online)

Please enclose copy of submission.

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