Connecticut Homeschooling Notice of Intent Form

NOTICE OF INTENT
INSTRUCTION OF STUDENT AT HOME


NAME OF STUDENT:         	DATE OF BIRTH: 

ADDRESS:		TELEPHONE #: 
	




NAME(S) OF TEACHER(S): 

ADDRESS:		TELEPHONE #: 





THE SUBJECTS TO BE TAUGHT ARE:  (YES)      (NO)

(REQUIRED)

READING	
WRITING	
SPELLING	
ENGLISH GRAMMAR	
GEOGRAPHY	
ARITHMETIC	
U. S. HISTORY	
CITIZENSHIP	
   (INCLUDING A STUDY OF
   TOWN, STATE, AND FEDERAL
   GOVERNMENTS

(RECOMMENDED)

   SCIENCE	

(OTHER)




TOTAL NUMBER OF DAYS SCHEDULED FOR INSTRUCTION:  

TEACHER'S METHODS OF ASSESSMENT OF STUDENT PROGRESS:





AN ANNUAL PORTFOLIO REVIEW WILL BE HELD ON OR ABOUT:  
		
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NOTICE OF INTENT
INSTRUCTION OF STUDENT AT HOME
PAGE 2



I ACKNOWLEDGE AND ACCEPT FULL RESPONSIBILITY FOR THE EDUCATION OF MY
CHILD IN ACCORDANCE WITH THE REQUIREMENTS OF STATE LAW.



			
	PARENTS 	Date



I ONLY ACKNOWLEDGE RECEIPT OF THIS FORM AND RENDER NO OPINION AS TO THE APPROPRIATENESS OF THE PLANNED PROGRAM.



			
	SUPERINTENDENT	Date

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That's all there is to it! We normally specify: a portfolio date of June 1, xxxx, 180+ days of instruction, a mix of tests, written reviews, and other examinations (for the methods of assessment), and indicate a simple YES for the subjects to be taught. This document can be obtained from your local school district, the state Department of Education, or you can use this form, just format it using the Arial or Helvetica font.