Fillable HOMESCHOOL LETTER OF INTENT

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HOMESCHOOL LETTER OF INTENT

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The HOMESCHOOL LETTER OF INTENT form is 2 pages long and contains:

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  • 41 other fields

Country of origin: OTHERS
File type: PDF

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Page 1 of 2
HOMESCHOOL LETTER OF INTENT
Date: ______________________
Superintendent (or Principal): ______________________
School District: ______________________
This letter of intent is to inform the school board that the following child(ren) will be provided with
a homeschool education in lieu of attending public/private school:
Name: ______________________ Gender: ____ D.O.B.: ______________________
Name: ______________________ Gender: ____ D.O.B.: ______________________
Name: ______________________ Gender: ____ D.O.B.: ______________________
Name: ______________________ Gender: ____ D.O.B.: ______________________
Address of Child(ren): _________________________________________________________
The child(ren) will be taught by ______________________ [Parent or Authorized Teacher] at
____________________________________________ [Address]. The following subjects will be
covered during the ____ [Number of Days] days of instruction:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
I agree to maintain a portfolio of materials that demonstrate proper educational instruction
provided to the child(ren) in the event that the _____________ [State] Department of Education
request such information.
Teacher Signature ______________________
Print Name ______________________
Email: ______________________ Telephone: ______________________
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Page 2 of 2
I agree that I am the legal parent/guardian of the child(ren) and hereby declare my intent to
homeschool said child(ren).
Parent/Guardian Signature ______________________
Print Name ______________________
Email: ______________________ Telephone: ______________________
Parent/Guardian Signature ______________________
Print Name ______________________
Email: ______________________ Telephone: ______________________
NOTARY CERTIFICATE (IF REQUIRED)
STATE OF ______________________
COUNTY OF ______________________
On this ____ day of ______________________, 20____, before me appeared
______________________, known to me or satisfactorily proven to be the person(s) whose
name(s) is/are subscribed to the within instrument, in my presence executed the foregoing letter
of intent and acknowledged that they executed the same as their free act and deed.
Notary Public Signature ______________________
Print Name ______________________
My commission expires: ______________________
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HOMESCHOOL LETTER OF INTENT

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Completed 1 March 2021

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