Home Education Notification Form

3301-34-02 Statement of Purpose
The purpose of the rules in this chapter is to prescribe conditions governing the issuance of excuses from school attendance under section 3321.04 of the Revised Code, to provide for the consistent application thereof throughout the state by superintendents, and to safeguard the primary right of parents to provide the education for their child(ren). Home education must be in accordance with law.

3301-34-03 Notification

(A) A parent who elects to provide home education shall supply the following information to the superintendent:

(1) School year for which notification is made; 20_____

(2) Name of parent,       _____________________________________________________
     Address,                 _____________________________________________________
 Telephone Number (optional);      ______________________________________________

(3) Name, address, and telephone number (telephone number optional) of person(s) who will be teaching the child the subjects set forth in paragraph (A) of this rule, if other than the parent:

     Name                     ____________________________________________________
     Address,                 ____________________________________________________
 Telephone Number (optional);      ____________________________________________

(4) Full name and birth date of child to be educated at home;
         ____________________________________________            ______________
         ____________________________________________            ______________
         ____________________________________________            ______________
         ____________________________________________            ______________
         ____________________________________________            ______________

 (5)  _______ Assurance that home education will include the following, except that home education shall not be required to include any concept, topic, or practice that is in conflict with the sincerely held religious beliefs of the parent;

(6) ________Brief outline of the intended curriculum for the current year. Such outline is for informational purposes only. (attached)

(7) List of

(8)     ___Assurance that the child will be provided a minimum of nine hundred hours of home education   each school year.

(9)     ___Assurance that the home teacher has one of the following qualifications:

(10) The parent(s) shall affirm the information supplied with his or her signature prior to providing it to the superintendent.

Signature_____________________________    Date________________