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IHBG-FRM1

Notice of Intent to Pursue a Program of Home Education

Instructions: Please complete this form, attach any additional information and forward at least 14 days prior to the intended start date of the home education program. If this process is initiated during the school year, the student must remain in school until the school district and the parents agree jointly to the home education plan.

Please send this completed form and any additional information to Jeffrey LaBroad, Assistant Superintendent, Hopkinton Public Schools, 89 Hayden Rowe Street, Hopkinton, MA 01748 or email jlabroad@hopkinton.k12.ma.us. 

A.

Parent Name

  

Address

  

Phone (days)

  

Email

  

Student(s)

  

D.O.B
   

D.O.B
   

D.O.B

 

B. On a separate sheet, describe the instructional program to be taught, including subjects and instructional aids to be used.
 
C. On a separate sheet, please indicate academic background, life experience and/or qualifications of those who will be instructing child(ren), as they relate to the instructional program described in Section B. This information will not be used to deny an application.
 
D. Check the method of assessment to be used, followed by a brief description.
  • Daily logs, journals, progress reports, portfolios, or dated work samples.
  • An independent report made by someone acceptable to both the Superintendent and parent(s) or guardian(s).
  • Standardized test results.
  • Consultation with the Superintendent or appropriate school principal.
  • Any other method agreed to by both the Superintendent and home educator(s)
 
The signature of the parent/guardian below indicates intent to provide a minimum of 900 (grades 1-8) or 990 (grades 9-12) hours of instruction.

 
_______________________________________                      _____________________
Signature of Parent/Guardian                              Date Submitted

 
The signature of the school official below indicates the final approval of this plan. 
 
_______________________________________                       _____________________
Signature of Superintendent or Designee          Date

 
For more information contact:
Jeffrey LaBroad
Assistant Superintendent
Hopkinton Public Schools 
89 Hayden Rowe Street Hopkinton, MA 01748

(508) 417-9360

jlabroad@hopkinton.k12.ma.us

 

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