Intent to Home School

The receipt of this form by the County Superintendent of Schools about your intention to home school your child(ren) will ensure compliance with Section 20-5-109(5), MCA. Receipt of this form also serves to notify home schools about opportunities to participate in federal education programs offered by the district of residence.

An immunization form should be completed if this is the first year as a home school or if changes have been made since last year.

These students will be enrolled in home school for the 20 -20 school year:

Student’s Name:		Date of Birth:	Grade
First	Last	(mo/day/yr)	(K-12)

Non Public Schools may participate in the following federal programs if offered by the school in the district of residence. A description of these federal programs is attached:

Title I Helping economically disadvantaged student meet high standards

Title II Dwight D. Eisenhower Professional Development Programs

Title III Safe and Drug-Free Schools and Communities

Title IV Innovative Education Programs

Title VI Bilingual Education, language enhancement

SE B Special Education (IDEA) Part B

SE P Special Education (IDEA) Preschool

SF Child Nutrition Education Programs

Vo Ed Carl Perkins Vocational Education

Please check one of the following:

I WISH TO RECEIVE A PARTICIPATION FORM

I DO NOT WISH TO RECEIVE A PARTICIPATION FORM

Students may participate in some activities that are held throughout the school year, i.e. County Spelling Bee and County Track Meet. Please indicate if you wish to be notified about these activities: yes no.

The County Superintendent does achievement testing each spring. If you wish to have your children tested, please call the office no later than February 1.

Name of Parent or Guardian (Please Print):	Signature:
Mailing Address:	Phone:	Date:
Residence (Physical Address – if different than Mailing Address):

Return completed form to:

Dawson County Superintendent of Schools

207 West Bell

Glendive, MT 59330