Statement of Intent to Educate Through a Home-Based Educational Program 2017-2018
2017-2018 Academic School Year
Valid from June 1, 2017 - June 2, 2018

A copy of this form will be sent to the Home-Based Education department of Jeffco Public Schools. That department will process it fourteen days after it's receipt.

One form per child please.

Student First Name *
Your answer
Student Middle Name *
If the child does not legally have a middle name, please type "n/a" or "no middle name"
Your answer
Student Last Name *
Your answer
Student's date of Birth *
MM
/
DD
/
YYYY
Your child's Registration Code or Student ID from Jeffco Connect
This step is optional. Please visit https://jeffcoconnect.jeffco.k12.co.us/ and set up an account for your family. Any information left blank will have to be completed by a Jeffco employee taking an educated guess. The Registration code can be found by click on your child's name, this will open the summary page, right above their name. If your child has been enrolled in Jeffco Schools before, they will already have a Student ID. You can enter either one.
Your answer
Student's Grade *
Home Address *
Street Address, City, State, Zip code
Your answer
Planned Number of hours of instruction hours per day (avg.) *
Home school programs must have no less than 172 days of instruction, averaging 4 contact hours per day. - CO Department of Edu
Your answer
Days per school Year *
Home school programs must have no less than 172 days of instruction, averaging 4 contact hours per day. - CO Department of Edu
Your answer
Parent's Name *
First & Last please
Your answer
Home School Enrollment History *
Please enter an email address if you would like to have a copy of the NOI delivered to your Inbox.
Please note, these may not be delivered to your inbox until mid-late August.
Your answer
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