Home School Enrollment Report 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 do not put your child's name on this form.  State law does not
require collection of students name
Parent Information
First Name   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.
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.
* All fields above are required
Type In The Number of Participating Students In Each Grade Level.
PK KG G1 G2 G3
G4   G5 G6   G7 G8
G9   G10 G11 G12  
** Must be a number between 0-10
Make sure to verify your responses before clicking the submit button. You will not be able to make any changes after submitting home school enrollment report form. 
Please note that you will not receive books or a curriculum as a result of filing this form with us.