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2024-25 Rebate Request

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Please complete the form if you paid CHALC fees as a member of two or more member groups.  The rebate is $15 for each additional membership.
1. *

Name:
2. *

Email:
3. *

I am a member of...

 (1 required)
Adventure Club CHASE
CHEX CHOS
Conestoga Valley Homeschoolers (Lancaster) Cornerstone Lower Tier
Cornerstone Upper Tier Evergreen
Firm Foundations Firmly Planted Classical Community
Heritage Homeschool Academy Learning Station
Manheim Area Christian Home Educators (MACHE) Second Plane Homeschool Collective
Solid Foundation T.E.A.C.H.
Treasures of Grace
4. *

Please choose one option:
I would like to receive my rebate(s). (Rebate will be mailed) I would like to donate my rebate(s) to CHALC. (Rebate will use to fund CHALC programs. Thank you!)

 

If you have chosen to receive your rebate(s), please provide your address:
5. 

Street Address:
6. 

City/Town:
7. 

Zip Code:
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