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AFFIDAVIT FOR HOME SCHOOL INSTRUCTION

Student Name M/F Birth Date Designated School Activities your student may participate in
with the principal’s permission
         
         
         
         
         

Parent/Guardian Name: __________________________________      Phone: ________________________

Address: ____________________________________________________________________________________

PARENT/GUARDIAN AFFIDAVIT

I, ______________________, (Parent/Guardian) of the above named student(s), declare my intent to home school my student(s).  I understand and agree:

  1.       To provide instruction in the subjects the Utah State Board of Education requires to be taught in public
  2. To provide instruction for 180 days and 990 hours each
  3. I am solely responsible for selecting instructional materials and
  4. I am solely responsible for setting the time, place and method of
  5. I am solely responsible for testing or otherwise evaluating the home school instruction my student
  6.       If my student is home schooled, he/she may only earn School District credit consistent with School District Policy IKF and Board Rule R277-700.
  7.       This home school instruction affidavit will be ongoing and remain in effect until the student(s) reaches graduation age or unless I notify the school district of plans to re-enroll the student(s) in public Any student re-enrolling in a district school must follow procedure outlined in District procedures.

I accept full responsibility for my student and understand that he/she may not qualify for a high school diploma issued by the South Sanpete School District or any of its schools.

(For students with IEPS or identified through child find): My decision to home school does not in any way imply that the school district did not provide a free and appropriate public education and I understand and agree that my student has no individual right to receive some or all of the special education and related services he/she would receive if enrolled in a public school in South Sanpete School District, unless I have arranged for dual enrollment consistent with state law, Section 53A-11-102.5 and the Utah State Board of Education rule, R277-438.

I have read this agreement and understand my obligations as a home school parent.

Note: The information on this form is for school/district use only. If schools/districts release home school student information as “directory information.” Schools/school districts must do so consistent with federal law

JEAA-1.pdf