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Notice of Intent to Operate a Home School (2013-2014 School Year)

Please answer each question on the form

Unfortunately, we cannot electronically submit your Notice of Intent to the North Carolina Division of Non-Public Education for processing until you have responded to each of the questions on the form.

If you have an unlisted telephone number (or you do not wish to provide one), simply enter 000 as your area code and 000-0000 as your telephone number. **Your currently valid e-mail address must be entered on the form in order to send it electronically.

Once you submit your Notice of Intent to Operate a Home School, you will receive (via an e-mail) a secured fax number that is designated to receive diploma evidence.


Notice of Intent to Operate a Home School
(Not for summer school only)
* Denotes information that is required in accordance with G.S 115C-548; 115C-552; 115C-560; 115C-563; 115C-564.
*NC County where the home is now located:   
*Home School Name:  
*US Mail Home Address -- Street or Box #:   or Box #:  
* City:  
State:  
* Zip Code:   (First 5 digits of your Zip Code)
 **E-Mail Address:   (Your Email Address is REQUIRED to submit this form.)
   ” If you do not wish to provide your phone number, leave 000 for your area code and 000-0000 for your number.“
 Home Telephone Number:  Area Code:    Telephone Number:   Required format: 000-0000
*School Owner:  
*Chief Administrator:  
First Name Middle Name Last Name
*Full names of adults providing academic instruction:  
  A)  
  B)  
  C)  
    
*Month & year school will begin initial operation in NC:     Month     Year  
*Under which Part of Article 39 do you elect to operate:  
*Student Enrollment:  (You must identify at least one (1) student.)
Female Ages: 6 7 8 9 10 11 12 13 14 15 16 17
Enrollment:
Male Ages: 6 7 8 9 10 11 12 13 14 15 16 17
Enrollment:

The North Carolina home school statutes require that Home Schools keep and maintain the following for one year:

  • Student attendance records for each student enrollee.
  • Student immunization records (or religious exemption statements) for each student enrollee.
  • Student achievement test result records.

When I submit this registration form:

  1. I am attesting that all information submitted by me via this form is accurate.
  2. I am agreeing to comply with the North Carolina statues concerning student records.
  3. I hereby give formal notice of the opening of the above named new home school as required by Chapter 115C, Article 39 of the North Carolina General Statutes.  I fully understand that this submission will become invalid if I do not fax within two business days diploma evidence for each instructor named above.

All information provided to DNPE becomes a public record in accordance with G.S. 132-1; 132-6; 115C-174.13, 564, 549 and 557.