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Full Name of Student
Student's Date of Birth
Address
Parent / Guardian's Full Name
First Date of Homeschooling
Address of Homeschooling Teacher
I ACKNOWLEDGE AND ACCEPT FULL RESPONSIBILITY FOR THE EDUCATION OF MY CHILD IN ACCORDANCE WITH THE REQUIREMENTS OF STATE LAW.
Today's Date
Sign Here
Parent's picture identification (examples below)
Upload ONE Parent / Guardian's ID from list above
FOR DISTRICT USE ONLY
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Superintendent's Approval
_________________________________________________ Date
