TENNESSEE NOTICE OF INTENT TO HOME SCHOOL
To be completed only by parent(s) conducting a home school under the supervision of the superintendent of a local education agency (LEA).
A "home school" is a school conducted by parent(s) or legal guardian(s) for their own children. This form may be utilized as notice of your intent to conduct a home school as permitted by T.C.A. § 49-6-3050. Please complete both pages of the form and return both pages to your local public school superintendent's office prior to each school year. Below is the information that will need to be provide on the form. The form can be viewed and printed using the link above
Part 1. Student Information
A. Grades K-8: For each student in grades K-8, you will need to provide the following information:
- Last Name
- First Name
- Age
- SSN (Optional)
- Grade
- Subjects to be taught
B. Grades 9 -12 For each student in grades 9 -12, you will need to provide the following information:
- Last Name
- First Name
- Age
- SSN (Optional)
- Grade
- Course of Study
- Subjects to be taught
ED 2541 (Rev. 09/2012)
TENNESSEE NOTICE OF INTENT TO HOME SCHOOL
Part II. Parent Information
Parents will need to provide the information listed below only for parent(s) or guardian(s) who will teach.
A. Name of parent(s) or guardian(s): Mother
B. List ONLY parent(s) or guardian(s) who will teach:
- Last Name
- First Name
- Parent or Guardian?
C. Contact Information:
- Home (mailing address)
- City
- Zip Code
- Phone Number
D. Parent's or guardian's education background (Complete ONLY for parent(s) or guardian(s) who will teach).
- For grades K-12, does the parent of guardian teaching have a GED or high school diploma? (Please state which one.)
- If mailing this form, please attach documentation of qualifying education. If presenting this form in person, please bring documentation of your qualifying education for school staff to verify.
Part Ill. Health Records
Please attach documentation indicating that student(s) have received immunizations as required by T.C.A. § 49-6-5001.
ED 2541 (Rev. 09/2012)
