Form HR-HS_150424 Additional forms are available in Student Portal
HOMESCHOOL RECORD
Student Name: ___________________________________________ Student Number: ___________________________
Daytime Telephone Number: _______________________________ Date: _____________________________________
Name of Teacher: ________________________________________ Relationship:____________________________________________
Teacher’s Credentials: _____________________________________________________________________________________________________
The following information must be provided for all courses taken in the student’s homeschool program. Each course must be listed separately. It is
important that the student attaches the course outline and/or textbook’s table of contents for each course listed, as well as a work sample from the
beginning, middle and end of the course.
Course Name Grade Level Year Taken Final Grade Textbook Title
Publisher/Copyright
Date
Portfolio
or Exam
Example : Ge
neral Math 9 9
5-96 B Refresher Steck-Vaugh/1995 Exam
If more space is needed to describe student’s educational experience, please make a copy of this form and continue to list on it.
Please complete this form and fax to 770.729.8578 or e-mail to registrar@jmhs.com.
If you have questions, please call James Madison High School’s Evaluation Advisors at 800.224.7234.
