Join Membership Enrollment Form School Name* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this a new membership or renewal?* New Renewal Contact Name First Last Email Choose one enrollment option: Member School within 100 mile radius of Sioux Center Member School outside 100 mile radius of Sioux Center Number of Students (K-12 students only, Pre-K not included)Membership Cost Price: $0.00 Membership Cost Price: $0.00 Total $0.00 Payment Options* Pay Online with Paypal (You will be redirected to Paypal for payment after clicking "submit") Pay by Check Please mail a check for the amount above to: Heartland Christian Schools 498 4th Ave NE Sioux Center, IA 51250
