Homeschool Enrollment Form

Created for Shanti Karthik by Nhan Nguyen on 12/4/2020 and modified for Elise Locke on 04/08/2022
Homeschool Enrollment Form

This form is to be completed by parents/guardians and pertains only to residents of the State of Indiana.

Please verify your responses before clicking the submit button. You will be able to make changes after submitting homeschool enrollment report form using the hyperlink in your confirmation email.

If you have any questions, please contact: studentpathways_homeschool@doe.in.gov
By choosing to homeschool my child(ren), I understand that, as the parent/guardian.*

I am taking complete responsibility for educating the child(ren);I select the curriculum and educational materials to be used;There is no state financial assistance for families who choose this option;Students who complete their education in homeschool will not receive a diploma accredited by the State of Indiana; andI may re-enroll my child(ren) in the public school corporation in which I reside at any time, however the school corporation has the right to place the child(ren) in the grade(s) and/or class(es) where the school believes the student will be most successful.
1. Registration Date

MonthDayYear
DateHourMinutesAM/PM Option
2. Email*

Confirmation Emailexample@example.com
3. Primary Parent/Guardian*

First NameLast Name
4. If your child would attend public school, in what county is this school located?*
5. In what public school corporation do you live?*
6. Parent/Guardian Indiana Mailing Address*

Street Address

Street Address Line 2

CityINDIANA (should be INDIANA)

Zip Code
7. Parent/Guardian Phone Number*
Participating Students in Each Grade Level (PK, KG, 1 to 12): Student Information First Name, Last Name, Current Grade and Date of Birth are required
Student Information
8. How many students in your homeschool?*
8-1-a. 1st Student Name*

First Name *Middle Name (optional)Last Name *
8-1-b. 1st Student Date of Birth*

MonthDayYear
Date
8-1-c. 1st Student Current Grade*
8-2-a. 2nd Student Name*

First Name *Middle Name (optional)Last Name *
8-2-b. 2nd Student Date of Birth*

MonthDayYear
Date
8-2-c. 2nd Student Current Grade*
8-3-a. 3rd Student Name*

First Name *Middle Name (optional)Last Name *
8-3-b. 3rd Student Date of Birth*

MonthDayYear
Date
8-3-c. 3rd Student Current Grade*
8-4-a. 4th Student Name*

First Name *Middle Name (optional)Last Name *
8-4-b. 4th Student Date of Birth*

MonthDayYear
Date
8-4-c. 4th Student Current Grade*
8-5-a. 5th Student Name*

First Name *Middle Name (optional)Last Name *
8-5-b. 5th Student Date of Birth*

MonthDayYear
Date
8-5-c. 5th Student Current Grade*
8-6-a. 6th Student Name*

First Name *Middle Name (optional)Last Name *
8-6-b. 6th Student Date of Birth*

MonthDayYear
Date
8-6-c. 6th Student Current Grade*
8-7-a. 7th Student Name*

First Name *Middle Name (optional)Last Name *
8-7-b. 7th Student Date of Birth*

MonthDayYear
Date
8-7-c. 7th Student Current Grade*
8-8-a. 8th Student Name*

First Name *Middle Name (optional)Last Name *
8-8-b. 8th Student Date of Birth*

MonthDayYear
Date
8-8-c. 8th Student Current Grade*
8-9-a. 9th Student Name*

First Name *Middle Name (optional)Last Name *
8-9-b. 9th Student Date of Birth*

MonthDayYear
Date
8-9-c. 9th Student Current Grade*
8-10-a. 10th Student Name*

First Name *Middle Name (optional)Last Name *
8-10-b. 10th Student Date of Birth*

MonthDayYear
Date
8-10-c. 10th Student Current Grade*
Should be Empty: