AFFIDAVIT OF THE SUPERVISOR OF A HOME EDUCATION PROGRAM
AFFIDAVIT OF THE SUPERVISOR OF A HOME EDUCATION PROGRAM
Supervisor’s Name: ____________________________________________________________________.
Address of the home education program site: ________________________________________________.
Phone number of the home education program site: ___________________________________________.
Student’s Name ____________________________________________________ Age ______________.
I attest that I am the parent, guardian, or legal custodian of the student.
I attest that I am the supervisor of the home education program and am responsible for the provision of instruction in the home education program.
I attest that I have earned a high school diploma or its equivalent.
I attest that the subjects required by law will be offered in the English language.
I attest that the student has received the immunizations required by law, or that the student has a medical, religious, or philosophical exemption.
I attest that the student has received the health and medical services required by law for students of the child’s age or grade level.
I attest that no adult living in the home, or any person having legal custody of the student, has been convicted within five years of today’s date of any of the criminal offenses enumerated in Section 111 of the Pennsylvania Consolidated Statutes.
I attest that the home education program shall comply with the provisions of Section 13-1327.1 of Pennsylvania Statutes Annotated and that the notarized affidavit shall be satisfactory evidence thereof.
Supervisor’s signature:
Notarization:
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- 2009 blue ribbon schools
- physical exam form pennsylvania department of health
- pittsburgh public schools
- edu
- city of pittsburgh allegheny county
- george westinghouse high school
- affidavit of the supervisor of a home education program
- school district chemical hygiene plan
- 2009 no child left behind blue ribbon schools program
Related searches
- the importance of psychology in education pdf
- the impact of technology on education article
- value of a college education statistics
- derivative of the area of a triangle
- the represents the domain of a function
- the failure of the american education system
- role of a special education teacher
- example of the theme of a story
- a the abundance of a ground beetle species in a meadow b the zonation of seaweed
- b of a home loan
- b of a home mortgage
- example of a home appraisal