NOTICE OF INTENT TO HOMESCHOOL
We, the undersigned parents and/or guardians, do hereby serve notice to the
Superintendent of School District _______________________ that we have established and are in charge and control of a non-public home-based educational program pursuant to C.R. S. 22-33-104.5
Children's Names Children's Ages
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Our place of residence is:
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The number of days of attendance for this school year is _________
(should be at least 172, averaging 4 hours per day.)
The test or evaluation results for our children will be submitted to:
_________________________ (name of school or district) when they are tested or evaluated upon completion of grades three, five, seven, nine, and eleven (NOTE: This part is optional, only fill it out the years you plan to test or evaluate.)
Signatures:
______________________________________ Date: __________
______________________________________ Date: ___________