Illinois State Board of Education
Data Analysis and Accountability Division
100 North First Street, S-284
Springeld, Illinois 62777-0001
Telephone #: 217/782-3950 Fax #: 217/524-7784
Home Schooling Registration
School Year Beginning in Fall __________ (provide year)
Directions: Please complete all areas of this form and return it to the Illinois State Board of Education at the address above. This form is
electronically llable or you may print a copy and complete it by hand—PLEASE PRINT.
PLEASE REMEMBER TO REGISTER EVERY SEPTEMBER.
Registration with the Illinois State Board of Education and/or your Regional Ofce of Education is voluntary.
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
(mm/dd/yyyy)
MALE FEMALE
_____ / _____ / _____
_____ / _____ / _____
_____ / _____ / _____
_____ / _____ / _____
_____ / _____ / _____
Provide information on the last public or nonpublic school attended (if applicable):
CHILD SCHOOL NAME
PUBLIC/ NONPUBLIC
(Check only one)
DATES OF ATTENDANCE
(mm/dd/yyyy)
_____ / _____ / _____
_____ / _____ / _____
_____ / _____ / _____
_____ / _____ / _____
_____ / _____ / _____
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) ______________________________________________________________________
______________________________________________________________________ _____________________________________________
Signature of Parent/Guardian Date
ISBE 87-02 (9/12)
Use your "Mouse" or "Tab" key to move through the fields, and the mouse to mark check boxes. After completing last field, save document to hard drive to make future updates or click print button.
