EmailMe Form - Notification of Home Education 2024-2025

What school year is this for? *
Which school would your child attend if he/she was attending public school? *
If "Other" was indicated above, please indicate which public school your child(ren) would attend.
Parent/Guardian's Name *
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone
### - ### - ####
Email
Will the parent/guardian be providing the instruction? *
Yes
No
Name of person who will be providing instruction if not the parent/guardian. *
First Last
Address of person providing instruction if not the parent. *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone number of the person providing instruction if other than the parent.
### - ### - ####
Name of first child *
First Last
School first child would attend if attending public school. *
The education program for the first child will include instruction in: (mark all that apply) *
English Language Arts
Mathmatics
Science
History
Government
Social Studies
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