HOMESCHOOL ENROLLMENT FORM
 This form pertains only to the residents of the State of Indiana.
Contact Information: homeschool@doe.state.in.us or 317-232-9111
Only parents and legal guardians may complete this form.
  Please include your child’s name, date of birth and grade on this form. 

PLEASE NOTE THAT YOU WILL NOT RECEIVE A BOOK OR A CURRICULUM AS A RESULT OF FILING THIS FORM WITH US
Make sure to verify your responses before clicking the submit button. You will not be able to make any changes after submitting homeschool enrollment report form. 
   
*Indicates required fields
* Parents First Name:
 
* Parents Last Name:
 
* In what public school corporation do you live?
 
* If your child would attend public school what county is this school located?
 
Mailing Address: The mailing address of the parent/guardian of the child, not the address of the child's public school.
* Address
 
* City
 
State
* Zip
 
 
Zip+4
Phone Number: The phone number of the parent/guardian of the child, not the phone number of the child's public school.
* Phone
 
Email
 
Participating Students in Each Grade Level (PK, KG, 1 to 12)
* Student Information

First NameLast NameMiddle NameSTN (Optional)Current GradeDate of Birth