Home Education Letter of Intent

* Required fields

What school year are you applying for? Please choose the student grade level for the school year selected.

Please enter the student’s legal name in the fields below.

First Name Last Name Birthdate Gender Federal Ethnic Category

Please select all races that apply.

Race: American Indian or Alaska Native No Yes

Race: Asian No Yes

Race: Black or African American No Yes

Race: Native Hawaiian or Other Pacific Islander No Yes

Race: White No Yes

Address & Contacts What county do you live in?

Residential Address

Street Address Apt / Unit (optional) City State Zip Code

Primary Parent/Guardian

First Name Last Name Relationship Preferred Contact Language Email Phone

In compliance with section 1002.41 (1)(a), Florida Statutes, this is written notice from the parent/guardian to establish and maintain a Home Education Program for the following child(ren). The parent/guardian is responsible for maintaining his/her child(ren)'s complete portfolio and learning log as well as submitting results of annual evaluations in compliance with section 1002.41, Florida Statutes.

Was the last school attended an OCPS school? No Yes

I have withdrawn my child from the following school: Please upload OCPS proof of withdrawal. Home Education Start Date I am aware that Home Education students are not awarded High School diplomas.

Parent/Guardian Signature

For Questions, Contact: Home Educationhomeeducation@ocps.net