HOME SCHOOL ATTENDANCE RECORD -- School Term
HOME SCHOOL ATTENDANCE RECORD -- School Term ____________ - ____________
County ____________________________ School Name ____________________________________________________________________________________
Name of Student _______________________________________________________________________________________________________________________
Last
First
Middle
Directions: SAVE THIS FORM AS A MASTER; make photocopies so that a separate form can be used for each student.
Keep completed form(s) on file at your school for later inspection.
Please check () dates below on which academic instruction and educational activities were conducted.
NC Division of Non-Public Education 1309 Mail Service Center
Raleigh, NC 27699-1309
Telephone: (919) 733-4276
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL MAY JUNE
By my signature below, I affirm that the above entered information, to the best of my knowledge, is accurate and truthful.
Chief Administrator ______________________________________________________ Date ___________________
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