Membership Application / Renewal – MDHSA Member Portal

Partial-Year Memberships Available beginning December 1.

New Full-Year Members: You will be able to access the Member Portal on June 1 when the new membership year begins. If you plan to participate in a co-op, you can access the co-op registration forms on the Member Portal beginning June 1. Check the forms for the registration deadline for new members.

Renewing Members: You can continue accessing the Member Portal through May 31 by using the current password. Beginning June 1, use the new password to access the Member Portal and co-op registration forms.

***MEMBERSHIP FEES ARE NON-REFUNDABLE***

Last Name*
Father's Name
Mother's Name
Member Since*	Renewing Members: What year did you first join MDHSA? See the Current member's directory or select "Not Sure." If you are a new member, use the current year.
Today's Date*
Address*	Use abbreviations when possible. (Rd, St, Dr, Ln, Ave. etc.)
City*
State*
Zip Code*	Use five-digit zip code only. No hyphens or four-digit extended zip codes.
Phone*	Enter phone number using hyphens (xxx-xxx-xxxx)
Secondary Phone	Enter phone number using hyphens (xxx-xxx-xxxx)
Email*
First Time or Renewal?*	First Time or Renewal? First Time Registration Renewal
Children Birth Years	For children 18 and under, list their birth years, oldest to youngest, separated by commas. ONLY USE THE LAST TWO DIGITS OF THE BIRTH YEAR (97, 99, 00)
Gender	List children's gender, oldest to youngest, separated by commas. Use M or F for gender.
Co-op*	If you are planning to be in a co-op this year, please indicate which one. Otherwise, choose "None." SELECTING A CO-OP DOES NOT REGISTER YOU FOR A CO-OP. A separate registration form and fee must be submitted to your co-op of choice. That information is available on the Members Portal.
Associate or Full*	Associate or Full A F If you fully agree with our Organizational Statements on the previous page, please select a Full Membership. If you do not fully agree, please select an Associate Membership. If you have a question or are unsure which membership category you should choose, please contact office@masondixonhomeschoolers.org for assistance.
MDHSA Newsletter*	MDHSA Newsletter Email Mail All MDHSA members receive the newsletter by email. To also have a hard copy printed and mailed to you, there is an extra $10 fee in addition to the $45 membership fee. Please check one.
To make sure you are not a spam-bot....*	What is the sum of 3 and 2?