2016-2017 Home School Notification Form
This form is used by the Prince George's County Public Schools in accordance with the State Board of Education regulation Title 13 A, Subtitle 10, Home Instruction, Chapter 01, General Regulations. Those Regulations establish procedures to determine if a student participating in a home schooling program is providing regular, thorough instruction during the school year.
This form is to be completed annually, prior to the start of each school year, to verify your intention to continue in the home school program.

IF YOU ARE COMPLETING A NEW HOME SCHOOL APPLICATION:
1. Complete this form for each child and click Submit.
2. An email confirmation will be sent to you. PRINT the email and SIGN the form.
3. Send a copy of the SIGNED FORM to the Home School Office via US Postal mail (Division of Student Services, Home School Office, 7711 Livingston Road, Oxon Hill, MD, 20745) OR via email to pgcps.homeschool@pgcps.org.
4. If your child is enrolled in a Prince George's County Public School, a copy of the endorsed Home School Application must be ​provided to the school​ for official transfer to Home School. ​Until that time, your child should continue attending the school of enrollment.

IF YOU ARE COMPLETING AN ANNUAL VERIFICATION OF YOUR INTENT TO HOME SCHOOL:
1. Complete this form for each child.
2. Click Submit.

Home Schooling Office Status *
Please Check One:
Captionless Image
Section I: Student & Parent/ Guardian Information
Parent/ Guardian Last Name *
Your answer
Parent/Guardian First Name *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Home Phone
Please enter your phone number using the following format: (301) 123-4567
Your answer
Email Address
Your answer
Student Last Name *
Your answer
Student First Name *
Your answer
Middle Name
Your answer
Suffix
Your answer
Student Gender *
Required
Date of Birth *
MM
/
DD
/
YYYY
Do you have multiple children participating in home school? *
Race
Is your child currently enrolled in a PGCPS school?
Next
Never submit passwords through Google Forms.
This form was created inside of PGCPS. Report Abuse - Terms of Service - Additional Terms