Superintendent of Schools
c/o Rich Hilgert
District Student Services
Notice of Intent to Establish a Home Education Program
In compliance with 232.0201 (1) (a), Florida Statute, this serves as written notice of intent
to home educate. The following information is required by law.
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Child's Name |
Date of Birth |
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1. |
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2. |
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3. |
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4 |
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5. |
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6. |
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Home Address: _____________________________________________________
_________________________________________________________________
X___________________________________________ Date:
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Signature of Parent or Guardian