Form 4140 at a glance
What it is: DOE Form 4140, Exceptions to Compulsory Education, is a State of Hawaii Department of Education form: I hereby request that the named child be withdrawn from school.
Where and when to file: A parent whose child has reached the fifteenth anniversary of birth and is suitably and lawfully employed shall complete and submit Form 4140 to the local public school for the principal's recommendation as to whether the exception should be granted. The form shall then be submitted to the district superintendent for approval.
A parent whose child is physically or mentally unable to attend school, deafness and blindness excepted, shall complete and submit Form 4140, Exceptions to Compulsory Education, to the local public school.
Approval for exceptions due to family court order shall be authorized by a family court judge. The approval of the family court judge shall be obtained on Form 4140.
The parent of a child requesting a compulsory attendance exception for an alternative educational program other than home schooling shall complete and submit Form 4140 to the local public school.
All parents choosing to home school their children must notify the local public school principal.
A filled-in Form 4140 example: a parent homeschools a sixth grader
How to fill out Form 4140, box by box
Student
Under Student, fill in Last, First, Middle, I.D. No., Birth Date, Age, Telephone Number, Address with Street, City and Zip, School, Complex Area and Grade.
A. Withdrawn from school for the school year
A. I hereby request that the named child be withdrawn from school for the school year in accordance with HRS §302A-1132.
Father/Guardian: (print or type name) Signature Date. Mother/Guardian: (print or type name) Signature Date.
B. Reason for withdrawal
Indicate with a checkmark in the column the reason for withdrawal. Choose one (1) option: 1) Disability, 2) Employment, 3) Family Court Order 4) Alternative Education, 5) Homeschooling.
1) EXCEPTIONS DUE TO DISABILITIES: Attach certificate of duly licensed physician.
2) EXCEPTIONS DUE TO EMPLOYMENT: After age 15. Attach verification of minor's employment status.
3) EXCEPTIONS PURSUANT TO FAMILY COURT ORDER: Attach court order.
4) EXCEPTIONS FOR ALTERNATIVE EDUCATION: Attach professional staff qualifications and child's instructional program. Program Name and Address. Phone. The parent requesting an exception under this section shall submit to the local public school principal a planned curriculum for the child along with the Form 4140.
Approval required
Approval required. (Signed Form 4140 Form original sent to parents and copy filed at the school of record) Principal and Complex Area Superintendent: Approval Recommended or Approval Not Recommended, with Signature and Date.
5) Homeschooling
5) HOMESCHOOLING The named child will be homeschooled from. Complete Form DOE 4140 (Rev. 8/23), Exceptions to Compulsory Education: Section A name of parent/guardian, signature and date; and Section B indicating with an “X” “Homeschooling” and inserting the date.
Acknowledgment required for homeschooling
Acknowledgment required for homeschooling. (Signed Form 4140 original sent to parents and copy filed at the school of record) Principal and complex area superintendent, with Signature and Date: check “Acknowledged” and not “Approval Recommended” or “Approval Not Recommended”; they are acknowledging receipt and not granting permission.
As long as parents are complying with the annual progress monitoring requirement (§8-12-18(b)), they do not have to resubmit the notification of intent to home school their child on an annual basis. However, another notification of intent must be submitted when the child is transferring from one local public school to another.
More rules for Form 4140
Requests for exceptions due to identified disabilities shall be renewed annually. Requests for exception due to employment shall be renewed annually. Requests for an exception due to family court order shall be reviewed and renewed annually. Requests for an exception for an alternative educational program other than home schooling shall be renewed annually.
Sources
[1] DOE Form 4140 (Rev. 8/23), Exceptions to Compulsory Education, State of Hawaii Department of Education (the Official source link on this page).