100 North First Street, E-222
Springfield, Illinois 62777-0001
Telephone: (217) 782-5270
HOME SCHOOLING REGISTRATION
SCHOOL YEAR BEGINNING IN FALL
______ (Provide Year)
REGULATORY SUPPORT AND WELLNESS DIVISION
Directions: Please complete all areas of this form and submit it to the Illinois State Board of Education at the following e-mail
address hsregist@isbe.net. This form is electronically fillable and you need to save it prior to submitting it via e-mail.
This completed form shall serve as notice to any school district, Regional Ofce of Education, or truant ofcer that the indicated parties
have registered with the Illinois State Board of Education as home school students.
Registration is voluntary and is not a requirement to home school students.
NAME(S) OF PARENT(S) OR GUARDIAN(S) COUNTY
ADDRESS (Street, City, State, Zip Code) TELEPHONE (Include Area Code) FAX (Include Area Code)
E-MAIL
Provide the full name of each child being taught and information for the current school year:
NAME GRADE
GENDER
DATE OF BIRTH
MALE FEMALE
_____-_____-_____
_____-_____-_____
_____-_____-_____
_____-_____-_____
_____-_____-_____
Provide information on the last public or nonpublic school attended (if applicable):
CHILD SCHOOL NAME
PUBLIC NONPUBLIC
DATE OF BIRTH
(Check only one)
_____-_____-_____
_____-_____-_____
_____-_____-_____
_____-_____-_____
_____-_____-_____
Provide the name of the curriculum to be used: ____________________________________________________________________
Education areas being taught (check all that apply):
(Section 26-1 of the School Code states that areas of education must be taught in the English Language)
Language Arts Mathematics Biological and Physical Sciences
Social Sciences Fine Arts Physical Development and Health
Other (please specify): _____________________________________________________________________________________
Use your "Mouse" or "Tab" key to move through the fields and check boxes. After completing last field, save document to hard drive to make future updates or click print button.
