Who will be signing this letter? One parent/guardianBoth parents/guardians Parent/Guardian Name: Parent/Guardian Name: How many children will be homeschooled? Select12345678910Child(ren) Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 2nd Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 3rd Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 4th Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 5th Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 6th Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 7th Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 8th Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 9th Child's Information Name: Gender: Gender: MaleFemale Date of Birth: 10th Child's Information Name: Gender: Gender: MaleFemale Date of Birth: At what address do the parents and child(ren) currently live? Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Will the child(ren) be taught at their home address? YesNo Address where the child(ren) will be educated: Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Who will be teaching the child(ren)? The parent(s)A separate teacher Teacher's Name: I understand that this letter must be signed by the teacher. I understand that this letter must be signed by the teacher. I understand. What is the name of your local School District? Find Your School DistrictIf you do not know the name of the school district, leave this box blank for now and a blank line will be added to the letter to be filled in later. Would you like to include the parent's contact information at this time? YesNo Parent's Email: Parent's Phone Number: 2nd Parent's Email: 2nd Parent's Phone Number: Do you want to include a section to be completed by a Public Notary? Yes (recommended)No What is the date of this letter? Next Save Save and finish later
