Intent To Homeschool Form Florida PDF Details

Embarking on the journey of homeschooling in Florida involves a crucial initial step: the submission of the Intent to Homeschool Form. This document, outlined under Section 1002.41 (a) of the Florida Statute, serves as formal notification that a parent or guardian intends to establish and maintain a home education program for their child or children. The form requests specific information, including the child's name, birthdate, grade, race, gender, last school attended, and the social security number—which remains optional. Additionally, it seeks details about the parent or guardian, including their name, mailing and physical addresses, contact numbers, and optional email address. This process not only ensures compliance with state laws but also aids in the collection of statistical data by the Florida Department of Education. Moreover, it is a declaration by the parent or guardian that they have understood the relevant statutes and policies related to home education in their district. Importantly, the form also underscores that neither Lake County Schools Home Education nor the Florida Virtual School awards high school diplomas, a critical aspect parents must acknowledge. With this submission, the document marks the beginning of a personalized educational journey, offering an alternate pathway to traditional classroom learning while maintaining adherence to legal requirements.

Form NameIntent To Homeschool Form Florida
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesnotice of intent to homeschool florida, intent to homeschool florida, florida notice of intent to homeschool, notice of intent homeschool florida

Form Preview Example


In compliance with Section 1002.41 (a), Florida Statute, this serves as the written notice of intent to establish and maintain a home education program for my child(ren). Please provide the following information required by law and/or necessary to maintain your records. Information on sex and race is being requested by the Florida Department of Education for statistical use only.

CHILD’S NAME (Please Print)





SSN (Optional)







Parent/Guardian Name: (Please Print)

Mailing Address:



Number, Street, or P.O. Box



Zip Code

Street Address:







(If Different)


Number, Street, or P.O. Box



Zip Code

Home Phone:



Work Phone:




Cell Phone:



E-mail Address:











I have read and fully understand the provision of Sections 1002.41, Florida Statutes and Lake County School District policies pertaining to compliance and enforcement of Home Education. The information contained herein is accurate and true to the best of my knowledge and belief.

I understand that neither Lake County Schools Home Education nor Florida Virtual School award high school diplomas._____________




Signature of Parent/Guardian


Date your program will begin

Send to: Jan Tobias

Additional Comments (if needed)


Student Services



512 S. Palm Avenue



Howey-in-the Hills, FL 34737



PHONE#: (352) 742-6920



FAX#: (352) 742-6921





Revised: July 2010

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The program will require you to fill out the I understand that neither Lake, Signature of ParentGuardian, Date, Date your program will begin, Send to, Jan Tobias, Additional Comments if needed, Student Services S Palm Avenue, and Revised July area.

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