Northern Nevada Home Schools

Notification of Intent to Homeschool

Pursuant to NRS 392.070 & NAC 392.011-392.065 as amended 10/23/04

 

Please complete a separate Intent Form for each child.  The form is required for children from age 7 to 17 only.

 

Section 1:

                                                          

1.  Biographical information:

 

Child.s Full Name: __________________________________________________________

                                     Last                                                           First                                                      Middle

 

Parent(s) Name: ____________________________________ Phone #: _______________

                                                                                                                                                                                               (If available)

 

Parent(s) Address: ____________________________________________________________

                                                                                                    City                                      Zip

 

Child.s Address: ________________________________________ Date of Birth: __________________

                                          (If different from parent )                   City                 Zip

 

2.  Declaration of responsibility:

Signed Parental Statement

I hereby assume full responsibility to assure that my child will receive the equivalent instruction

required by NAC 392.035, and that all biographical information is true and accurate.

 

     _____________________________________________________   ____________________

                    Signature                                                              Relationship to child                                                  Date

 

3. Parent has the option of signing the below to protect their privacy:

     Privacy Statement (optional)

     I expressly prohibit the release of any and all information contained in this document, including

     directory information as defined in 20 U.S.C. 1232g (a)(5)(A), without prior written consent by the

    under-signed.  See 20 U.S.C. 1232g (a)(5)(B) and NRS 392.029.

 

    ____________________________________________   ____________________________

                              Signature                                                               Date

 

*Upon receipt of a Notification of Intent to Homeschool that is complete and complies with homeschooling regulation, the school district shall provide to the parent who filed the notification a written acknowledgment which clearly indicates that the parent has provided the notification required by law and that the child is being homeschooled for the duration of the school year.  The written acknowledgment shall be deemed proof of compliance with Nevada.s compulsory attendance laws and is effective for one school year.

 

10/25/04                                          This form complies with requirements set forth in NAC 392.022, 392.024 & 392.026

 

 

NOTIFICATION OF INTENT TO HOMESCHOOL*

Pursuant to NRS 392.070 & NAC 392.011-392.065 as amended 10/23/04

Please complete a separate Intent Form for each child.  The form is required for children from age 7 to 17 only.

 

Section 2:  If this is an initial notification complete this section.

 

NAC 392.011(4) An Initial Notification must be filed when:

1)  The child reaches the age of 7 as specified in NRS 392.040; or

2)  The parent has received a written acknowledgment from one Nevada district that the child is being

homeschooled, and the child has moved to another district.  The initial filing must be submitted in the new

district at the beginning of the next school year; or

3)  The child has moved from out of state into a Nevada school district.  The initial filing must be submitted

within thirty days of establishing residency; or

4)  The parent begins homeschooling the child after discontinuing another educational method, as defined by

NRS 385.007.

1. Attach a statement of the educational plan for the child which must consist of either:

A.  The proposed educational goals (NAC392.011, #3) which is a description of the anticipated kind of

instruction, by subject, for one school year; or

B.  Instructional materials to be used (NAC 392.011, #2) which is a list of any items that may be used for

instruction, including but not limited to books, library materials, software, or a correspondence program.

Please refer to NAC 392.035 regarding the required instruction: kind, timing, amount, and discretionary assistance.

2.  Attest by check mark and initialing that I have:

  ____ At least one year of homeschooling experience in any state or territory of the United States: or

  ____ A teaching credential from any state or territory of the United States: or

  ____ Read and understand Nevada homeschool regulations, NAC 392.011 to 392.065, inclusive.

3.  You must show a birth certificate, or some other document sufficient to establish the child.s

      identity with the Initial Notification only. The document will not be photocopied or kept on file

      by the school district.

4.  If a Nevada public school was attended within the previous year, list name and city of school:

_____________________________________________________________________________

                         Name of School                                                               City                                                      County

10/25/04                                          This form complies with requirements set forth in NAC 392.022, 392.024 and 392.026