Letter of Intent to Continue Homeschooling

Information in the Letter of Intent to Continue Homeschooling must be submitted by October 1st of each year after a Full Report has been filed in the same district. If you have moved, you must file a new Full Report.

Please note that you will not be able to attach immunization records or other attachments. Please email or mail any additional documents to: dipaprocki@rochesterschools.org or Rochester Public Schools, Diane Paprocki, 615 7th Street SW, Rochester, MN 55902.

Request for student aide reimbursement, questions can be directed to Tanner Sorenson, Purchasing, 3935 Hwy 14 East, Rochester, MN 55904. (507) 328-4410

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* 1. Today's Date:

Date / Time

Date

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* 2. Please list the name(s) of all student(s) that this Letter of Intent to Continue applies to:

Name

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* 3. This letter indicates my intent to continue homeschooling in the current school year. Pursuant to Minnesota Statute 120A.24 subd. 1(b), we provide you with this letter of intent to continue our home education as reported previously and on file in your district office.

I Do NOT have changes to the information reported to the school district in the Full Report or communicated in a previous Letter of Intent to Continue Homeschooling.

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* 4. The following are changes and additions for this reporting period (if any).

New student(s) to report: (Provide name, date of birth, immunization information or conscientious exemption to immunizations and address if different from residence.)

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* 5. The following are changes and additions for this reporting period (if any).

Name

Address

City

State

Zip Code

Date of Birth

Grade Level

No longer homeschooling

New to homeschooling

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* 6. The following are changes and additions for this reporting period (if any).

Name

Address

City

State

Zip Code

Date of Birth

Grade Level

No longer homeschooling

New to homeschooling

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* 7. The following are changes and additions for this reporting period (if any).

Name

Address

Address 2

State

Zip Code

Date of Birth

Grade Level

No longer homeschooling

New to homeschooling

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* 8. Immunization information: If you are reporting a student who was listed on your initial Full Report who has reached seventh grade (age 12), attach (to this email) an immunization statement or a notarized statement of conscientious exemption to immunization because of the beliefs of the parent or guardian (if not already on file at the current school district). Below is the name of the student(s) who's immunization records you are emailing (megoetsch@rochesterschools.org) or mailing (615 7th Street SW, Rochester, MN 55902 Attn: Melissa Goetsch) :

Name

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* 9. Assessment changes: Report any changes in the assessment or method of assessment other than previously reported. If no change is listed below for any child listed above as a new student, we will be using the previously reported tests and administration procedures. Agreement with these arrangements is assumed unless the non-public school is contacted in a timely manner. The following nationally norm-referenced standardized achievement test will be used:

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* 10. Other changes to the reports on file for addresses, instructor information and accreditation (if any):

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* 11. Parent Contact Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number