* 1. What is your first name?

* 2. What is your last name?

* 3. What is your email address?

* 5. What school/homeschool group are you associated with?

* 6. Which class would you or your child(ren) be interested in taking?

* 7. When would you want to begin this class?

* 8. Do you give permission to be contacted with more information concerning my virtual math courses and to be added to my email list?

* 9. If I get enough people signed up to take my virtual class, how likely will you enroll your child? (1 = not very likely, 10 = very likely)

* 10. Any questions or comments?

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