Home Educators of Faith
Nevada Written Notice of Intent to Homeschool Form

Child's Full Name _________________________________________________________
Age of Child ________________  Child's Gender: M or F
Parent(s) Name ___________________________________________________________
Parent(s) Address__________________________________________________________
City/State/Zip _____________________________________________________________

Parent(s) Mailing Address (If Different From Above)__________________________________
City/State/Zip _____________________________________________________________

I declare that I am the parent, custodial parent, legal guardian or other person in this State
who has control or charge of the child and the legal right to direct the education of the child
and as such, assume full responsibility for the education of the child while the child is being
homeschooled.

Parental Signature __________________________________________________________
Relationship to Child ____________________________________Date________________

"The parent of a child who is being homeschooled shall prepare an educational plan of instruction for the child
in the subject areas of English, including reading, composition and writing, mathematics, science and social
studies, including history, geography, economics and government, as appropriate for the age and level of skill
of the child as determined by the parent. The educational plan must be included in the notice of intent to
homeschool form. The parent is not required to ensure that each subject is taught each year that the child is
homeschooled. An educational plan that contains these requirements must not be used in any manner as a basis
for denial of a notice of intent to homeschool that is otherwise complete."

My educational plan:
___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

If applicable, list the name of the most recently attended Nevada public school:
Name of School ________________________________City ______________Year  _______

An optional statement that the parent may sign which provides: I expressly prohibit the
release of any information contained in this document, including, without limitation, directory
information as defined in 20 U.S.C. ' 1232g(a)(5)(A), without my prior written consent.

Signature_______________________________________________Date_________________

You may mail in your Notice of Intent to Homeschool to your local homeschooling district's office or drop it
off, please do not send to Home Educators of Faith. This form complies with the requirements of NRS 392.070.
Effective July 1, 2007.