A parent/guardian who intends to cause his/her child(ren) to receive home-based instruction in lieu of attendance or enrollment in a public school, approved private school or an extension program of an approved private school, must file an annual declaration of intent to do so in the format prescribed below.
Please complete a new form for each child intended for Home Based Instruction.
I do hereby declare that (1) I am the parent, guardian, or legal custodian of the child(ren) listed below; (2) said child(ren) is (are) between the ages of eight and eighteen and as such are subject to the requirements found in Chapter 28A.225 RCW, Compulsory Attendance; (3) I intend to cause said child(ren) to receive home-based instruction as specified in RCW 28A.225.010; (4) I have received a copy of South Whidbey District Policy 2115, Home-Based Instruction; and (5) if a certificated person will be supervising the instruction, I have indicated this by checking the appropriate space.
This statement must be filed annually by September 15 or within two (2) 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.
Failure of a parent to comply with the standards as specified in this policy shall constitute a violation of the compulsory attendance law.