Declaration of Intent to Provide Part-Time Home-Based Instruction*

A parent who intends to cause his/her child or children to receive home-based instruction in lieu of full-time attendance or enrollment in a public school, approved private school, or an extension program of an approved private school must file an annual declaration of intent. State law specifies that the statement shall be written in a format prescribed by the superintendent of public instruction. The state has provided a format suitable for full-time home-based instruction. The format is not suitable for part-time home based instruction. This form is an unofficial adaption of the state-provided format*, and is more suitable for part-time instruction than is the state-provided format. A declaration of intent to homeschool must be filed annually by September 15 or within two weeks of the beginning of any public school quarter, trimester, or semester. State law requires that the prescribed form be filed with the superintendent of the public school district within which the student resides, or the district that accepts the transfer. Public School District: Seattle School District No. 1 Child's Name: ___________________________________________ Child's Age: 8___ Subject(s) that will be addressed through partial homeschooling: _______________ Parent/Guardian(s): _________________________________ __ District Address: Seattle School District No. 1 [Superintendents Designee 1330 North 90th Street, Building 200 Seattle, WA 98103] School at which child is currently enrolled:________________________________ School Address: ____________________________________________________ Principal: _________________________________________________________ [Instructions: Edit the following statement as appropriate.] I do hereby declare that I am the parent, guardian, or legal custodian of the child listed above; that this child is between the ages of 8 and 18 and as such is subject to the requirements found in chapter 28A.225 RCW Compulsory Attendance; I intend to cause my named child to receive parttime home-based instruction, as specified in RCW 28A.225.010(4), for only the specific subjects listed above. Apart from the listed subjects, the named public school will retain full responsibliity for the education of my named child, pursuant to RCW 28A.150.350, which requires that school districts provide part-time instruction to eligible students. My child is an eligible for part-time and full time instruction in the named school district.. My child is currently enrolled at the named school. ( ) The home-based instruction will be supervised by a person certificated in Washington State pursuant to chapter 28A.410 RCW and chapter 28A.225.010(4)(a) ( ) The home-based instruction will be NOT be supervised by a third party, as chapter 28A.225.010(4)(b) is applicable.

*Adapted from a sample form provided in the OSPI Pink Book (2003).\

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[Page 2 of Declaration of Intent to Provide Part-Time Home-Based Instruction*]

[Instructions: Delete or edit this note as appropriate.] Notes: Unless illness or some other circumstances warrant, I will take my child off-site during her classroom's regularly scheduled math period, in order that I may provide math instruction to him/her, and so as not to interfere with the duties of the school toward my child. Each day, unless circumstances otherwise warrant, I will return him/her to school at the beginning of the subsequent period. Name of parent/guardian signee: __________________________________ Parent/Guardian Signature: _______________________________________ Date: _____________________ Street Address: City, State Zip: ___________________________ ________________________

Some State Laws and Administrative Code

RCW 28A.41.140. Recodified as RCW 28A.150.260. Annual basic education allocation of funds according to average FTE student enrollment. [Partial homeschooling affects district allocation from state.] RCW 28A.41.145. Recodified as RCW 28A.150.350. [See below.] Laws pertaining to intradistict enrollment opportunities: Full text of these laws appear in Appendix 1 of The Pink Book. Part One of The Pink Book provides answers to frequently asked questions about RCW 28A.225. 28A.225.270 Intradistrict enrollment options policies. 28A.225.280 Transfer students' eligibility for extracurricular activities. 28A.225.290 Enrollment options information booklet. 28A.225.300 Enrollment options information to parents. 28A.225.310 Attendance in school district of choice
RCW 28A.150.350 Part time students -- Defined -- Enrollment authorized -Reimbursement for costs --Funding authority recognition -- Rules, regulations.... (2) The board of directors of any school district is authorized and, in the same manner as for other public school students, shall permit the enrollment of and provide ancillary services for part time students: PROVIDED, That this section shall only apply to part time students who would be

otherwise eligible for full time enrollment in the school district. [For answers to frequently asked questions about this law, see Part Three of The Pink Book.]

RCW 28A.195.010. Approved Private SchoolsExtension Programs for Parents to Teach Children in Their CustodyScope of State Control. [For answers to frequently
asked questions about this law, see Part Two of The Pink Book.] RCW 28A.200. Home-based instruction. [For answers to frequently asked questions about this law, see Part One of The Pink Book.] RCW 28A.200.010 Home-based instruction Duties of parents. Each parent whose child is receiving home-based instruction under RCW 28A.225.010(4) shall have the duty to: (1) File annually a signed declaration of intent that he or she is planning to cause his or her child to receive home- based instruction. The statement shall include the name and age of the child, shall specify whether a certificated person will be supervising the instruction, and shall be written in a format prescribed by the superintendent of public instruction. Each parent shall file the statement by September 15 of the school year or within two weeks of the beginning of any public school quarter, trimester, or semester with the superintendent of the public school district within which the parent resides or the district that accepts the transfer, and the student shall be deemed a transfer student of the nonresident district. Parents may apply for transfer under RCW 28A.225.220;.....(b)...(c)...[2]...http://apps.leg.wa.gov/rcw/default.aspx? cite=28A.200.010; full text in Appendix of Pink Book.

RCW 28A.200.020 Home-based instruction -- Certain decisions responsibility of parent unless otherwise specified. The state hereby recognizes that parents who are causing their children to receive homebased instruction under RCW 28A.225.010(4) shall be subject only to those minimum state laws and regulations which are necessary to insure that a sufficient basic educational opportunity is provided to the children receiving such instruction. Therefore, all decisions relating to philosophy or doctrine, selection of books, teaching materials and curriculum, and methods, timing, and place in the provision or evaluation of home-based instruction shall be the responsibility of the parent except for matters specifically referred to in this chapter. WAC 392-134-010 Attendance rights of part-time public school students. Statutory authority RCW 28A.41.145. See Appendix 1 of The Pink Book. WAC 392-134-015 Enrollment practices and conditions. Statutory Authorities: RCW
28.41.140 [28A.41.140] and 28A.41.145.

WAC 392-134-020 Provision of educational program to part-time public school\students. Specifies expenses that must be borne by and services that must be provided by school district; addresses privacy of student records. Statutory Authorities:
RCW 28.41.140 [28A.41.140] and 28A.41.145.

Additional References

The Pink Book. WASHINGTON STATES LAWS REGULATING HOME-BASED INSTRUCTION, State Superintendent of Public Instruction, Revised, February 2003. Office Of Superintendent of Public Instuction. www.k12.wa.us/PrivateEd/HomeBasedEd/PinkBook/A-6.pdf State Board of Education Examples of Approved Standardized Achievement Tests for Home-Based Instruction Use. The Pink Book, OSPI (2003), p. A-3. Declaration of Intent to Provide Home-Based Instruction, Sample Format Only. The Pink Book, OSPI (2003), p. A-2. Request for Part-Time Attendance or Ancillary Services From Private School Student or a Student Receiving Home-Based Instruction, The Pink Book, OSPI (2003), p. A-1 Responses to Questions Relating to Chapter 28A.225 RCW and Chapter 28A.200. The Pink Book, OSPI (2003), Part One,. Responses to Questions Relating to RCW 28A.195.010. [Approved Private Schools Extension Programs for Parents to Teach Children in Their CustodyScope of State Control] The Pink Book, OSPI (2003), Part Two. Responses to Questions Relating to RCW 28A.150.260. The Pink Book, OSPI (2003), Part Three. Washington Homeschool Organization. http://washhomeschool.org/; WHOoffice@foxinternet.net. "The Washington Homeschool Organization (WHO) is a statewide, non-profit membership organization. Its mission is to serve the diverse interests of home-based education in Washington State. WHO is nonpartisan, nonsectarian, and non discriminating in its views of homeschooling and participation in its activities." Information and Resources; Support Groups and Co-ops. www.homeedmag.com/groups/100/washington-laws-regulations