Intent To Homeschool Florida Form in PDF
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In Florida, families wishing to educate their children at home must complete the Intent To Homeschool form, a vital step in establishing a home education program. This form serves as a formal notification to the local school district, ensuring compliance with state regulations outlined in Section 1002.41 of the Florida Statutes. Parents or guardians need to provide essential information about their child, including the child's name, birthdate, grade, race, and last school attended. While the Social Security Number is optional, it can be helpful for record-keeping purposes. The form also requires the parent or guardian's name, mailing address, and contact details, including phone numbers and an optional email address. Acknowledgment of understanding regarding the relevant statutes and district policies is necessary, along with a signature and the date the home education program will commence. This form not only helps maintain accurate records but also ensures that families are aware of the legal framework surrounding home education in Florida. By submitting this form, parents take an important step in shaping their children's educational journey.
Form Example
HOME EDUCATION
In compliance with Section 1002.41 (a), Florida Statute, this serves as the written notice of intent to establish and maintain a home education program for my child(ren). Please provide the following information required by law and/or necessary to maintain your records. Information on sex and race is being requested by the Florida Department of Education for statistical use only.
CHILD’S NAME (Please Print) |
BIRTHDATE |
GRADE |
RACE/ |
LAST SCHOOL ATTENDED |
SSN (Optional) |
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GENDER |
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Parent/Guardian Name: (Please Print)
Mailing Address:
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Number, Street, or P.O. Box |
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City/State |
Zip Code |
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Street Address: |
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(If Different) |
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Number, Street, or P.O. Box |
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City/State |
Zip Code |
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Home Phone: |
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Work Phone: |
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Cell Phone: |
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(Optional) |
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I have read and fully understand the provision of Sections 1002.41, Florida Statutes and Lake County School District policies pertaining to compliance and enforcement of Home Education. The information contained herein is accurate and true to the best of my knowledge and belief.
I understand that neither Lake County Schools Home Education nor Florida Virtual School award high school diplomas._____________
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PLEASE INITIAL HERE |
Signature of Parent/Guardian |
Date |
Date your program will begin |
Send to: Jan Tobias |
Additional Comments (if needed) |
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Student Services |
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512 S. Palm Avenue |
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PHONE#: (352) |
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FAX#: (352) |
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Revised: July 2010 |
Document Breakdown
| Fact Name | Fact Description |
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| Governing Law | The Intent to Homeschool form is governed by Section 1002.41 of the Florida Statutes. |
| Purpose | This form serves as written notice to establish and maintain a home education program for children. |
| Information Required | Parents must provide information such as the child’s name, birthdate, grade, race, and last school attended. |
| Optional Information | Social Security Number (SSN) and email address are optional for parents to provide. |
| Statistical Use | The Florida Department of Education requests sex and race information for statistical purposes only. |
| Compliance Acknowledgment | Parents must acknowledge that they understand the provisions of Section 1002.41 and local school district policies. |
| Diploma Clarification | Neither Lake County Schools Home Education nor Florida Virtual School awards high school diplomas. |
| Submission Details | The completed form should be sent to Jan Tobias at the specified address in Howey-in-the-Hills, FL. |
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