Fillable I Tennessee Notice of Intent to Home School (State of Tennessee)

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I Tennessee Notice of Intent to Home School (State of Tennessee)

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The I Tennessee Notice of Intent to Home School (State of Tennessee) form is 2 pages long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for State of Tennessee

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I
Tennessee Notice of Intent to Home School
To be completed by school system:
School system name:
System number:
Date received:
Received by name:
Signature:
Title:
This form should be completed only by parent(s) conducting a home school under the supervision of the
superintendent of a local education agency (LEA).
“Home schools” are schools conducted by parents or legal guardians for their own children, which are distinct from
degree-granting online or distance education schools. This form may be utilized as notice of your intent to conduct
a home school, meaning that you will serve as the primary teacher for the student(s) as permitted by T.C.A. §49-6-
3050. Please complete both pages of the form and return both pages to your local public school system
office before the start of each school year.
PLEASE PRINT
Part 1. Student Information
A.
Grades K–8: For each student in grades K–8, please list the following information:
1.
Last name
First name
Grade
Age
Birthdate
Social security number
(optional)
2.
Last name
First name
Grade
Age
Birthdate
Social security number
(optional)
3.
Last name
First name
Grade
Age
Birthdate
Social security number
(optional)
4.
Last name
First name
Grade
Age
Birthdate
Social security number
(optional)
B.
Grades 9–12: For each student in grades 9–12, please list the following information:
1.
Last name
First name
Grade
Age
Birthdate
Social security number
(optional)
2.
Last name
First name
Grade
Age
Birthdate
Social security number
(optional)
Tennessee Notice of Intent to Home School
Part 2. Parent Information
Please provide information only for the parent(s) or guardian(s) who will teach.
Last Name First Name
A.
Name of parent(s) or guardian(s) (Mother)
(Father)
or
(Guardian)
B.
Contact Information
Home (Mailing Address)
City Zip Code
Phone Number ( )
Email Address
C.
Parent/Guardian Educational Background (complete only for parent(s)/guardian(s) who willteach)
1.
For grades K–12, I have a GED or high school diploma. Yes No
2.
If mailing this form, please attach documentation of qualifying education. If presenting this form in
person, please bring documentation of your qualifying education for school staff to verify.
Part 3. Health Records
Please attach documentation that student(s) have received immunizations as required by T.C.A. § 49-6-5001.
_
Parent/Guardian Signature Date
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I Tennessee Notice of Intent to Home School (State of Tennessee)

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Completed 11 August 2020

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