Home School and Educational Disabilities
The following form will collect information from parents who choose to homeschool their child who is identified with an educational disability.  Providing this information to CCS will ensure that the district will reevaluate a student every three years, which is required by law (Child Find 3301-51-03).  
Email *
What is your child's full name? 
First Name:
Middle Initial:
Last Name:
 *
What is your child's date of birth? *
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What is your child's gender *
What is your child's race? *
Required
What language is spoken at home? *
What is the mother's name? (guardian) 
First Name: 
Last Name:
What is the father's name? (guardian)
First Name: 
Last Name: 
What is your home address?
Number & Street Name:
City & State:
Zip Code:
 *
What county do you reside in? *
What is your email?
What is your phone number? *
What is the current grade of the child? *
What educational disability does your child have?
Indicate the meeting date of the most recent Evaluation Team Report (ETR) that was completed for your child.   See sample below of where you can find the meeting date from the last Evaluation Team Report (ETR).  This would be located on the top right hand corner of the front page.
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Thank you.  The information you provided will help ensure that your child's special education records stay up to date.  If there is anything else you would like the district to know then please share below.
A copy of your responses will be emailed to .
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