2019-2020 Adams County OH Valley Home Education Notification Form
A parent who elects to provide home education shall supply the following information to the superintendent.
Parent First Name *
Your answer
Parent Last Name *
Your answer
Parent Address *
Your answer
Parent City *
Your answer
Parent State *
Your answer
Parent Zip *
Your answer
Parent Phone # *
Your answer
Parent Email *
Your answer
Do you prefer to communicate primarily by email? *
Full name and birth date of child to be educated at home:
Child 1 First Name *
Your answer
Child 1 Last Name *
Your answer
Child 1 Date of Birth *
MM
/
DD
/
YYYY
Child 1 Grade Level
Would you like to add another child? *
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