DECLARATION OF INTENT TO HOME SCHOOL
By completing this form you declare you are the parent/guardian/legal custodian of the child(ren) listed below, and that said child(ren) is (are) between the ages of eight and eighteen and as such are subject to requirements found in Chapter 28A.225 RCW, Compulsory Attendance. You also declare your intent to provide said child(ren) home-based instruction as specified in RCW 28A.225.010(4). In accordance with RCW 28A.225.010, the Declaration of Intent to Home School must be filed annually by September 15 or within two weeks of the beginning of any public school quarter, trimester, or semester with the Superintendent of the public school district within which the parent resides.
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School Year *
Please select one: *
Student Information
Below you will enter information regarding the child who will be receiving home-based instruction. You will need to submit a separate form for each child receiving home-based instruction.

Please note, the Washington Graduation Year is established the year a student is identified as a 9th grader.  Grade level cannot be changed after the Washington Graduation Year has been set.
Child's First Name *
Child's Last Name *
Child's Age *
Parent/Guardian Information
Parent/Guardian First Name *
Parent/Guardian Last Name *
Street Address (Number and Street Name) *
Zip Code *
The home-based instruction will be supervised by a person certificated in Washington State pursuant to RCW 28A.410. 
(Check this only if you have hired a WA certified teacher to provide oversight as your method of qualifying to homeschool)
 *
Electronic Signature 

In providing your electronic signature below, you verify that all information contained in this declaration to be accurate and in accordance with RCW 28A.225.

Full Name Parent/Guardinan
 *
Today's Date *
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