Clark County School District
(Pursuant to NRS 392.070 & NAC 392.015 through 392.075)
For office use only: Date to Board____________________________________
STUDENT NAME_____________________________DATE OF BIRTH_____________________
SCHOOL YEAR TO BE EXEMPTED_____________EXEMPTION GRADE_________________
LAST SCHOOL ATTENDED OR HOME SCHOOLING_________________________________
PARENT(S) / LEGAL GUARDIAN(S)__________________________________________________
I, as a parent / legal guardian, agree to assume full responsibility to provide equivalent instruction at home of the kind and amount approved by the Nevada State Board of Education (NRS 392.070) to constitute equivalent instruction, the instruction to be given a child outside the public school must include instruction in the courses of study prescribed by the state board or eduation pursuant to NRS 385.110. The courses of study prescribed by the state board must comply with the standards of content and performance as found on the Nevada State Department of Education website at www.nde.state.nv.us and grade level curriculum overviews available in the CCSD homeschooling office.
[ ] Instruction and appropriate curriculum will be provided to teach the Nevada State standards. [NAC 392.025(1)]
Parent / Legal Guardian Signature ________________________________Date_______________
[ ] OPTION A BY PARENT
Parent has previously home schooled and is requesting an exemption for another year.
_______________________ ________________________ ___________________
Previous years City State
If previous home schooling was done out of district, documentation will need to be provided.
[ ] OPTION B CONSULTANT
1. [ ] By the Parent in Consultation / Consultant
Instruction is provided in consultation with threea parent who has home schooled for at least three years. NAC 392.011 (2) “Consultation means:
1) Participation by the consultant in the preparation of the educational plan for the child
2) Participation by the consultant in the development or review of the subjects to be taught; and
3) Consultation with the parent about any learning problems which may occur.
THE DISTRICT DOES NOT ENDORSE ANY CONSULTANT. INFORMATION ON CONSULTANTS IS AVAILABLE IN THE HOMESCHOOLING OFFICE.
Home Educator Consultant:
I will provide consultation in the following areas: (a) assistance in meeting the educational standards, (b) be available to the parents9s) to discuss any problems which may occur during the 2002-2003 school year.
I, ________________________, am a Home Educator Consultant with ___________ years experience. I have home schooled at the elementary/secondary grade level in__________________________________________
____________________________________________________________________________ Signature of Home Educator Consultant Phone number
2. [ ] By parent in consultation / teacher
Instruction is provided in consultation with a Nevada licensed teacher who is licensed for the grade to be taught.
I, ______________________________, am licensed to teach in Nevada with endorsement in
[ ] elementary [ ] secondary subjects, license #_____________________ an expiration date
of ______________________. __________________________________________________
Signature of licensed teacher with copy of license
[ ] OPTION C PARENT/ GUARDIAN LICENSED TEACHER
Instruction from the child’s parent if, the parent qualifies for a teaching license from any state or territory of the United States for the grade to be taught. (attach copy of license)
___________________________________ __________________ __________________ Name License number Expiration date
[ ] OPTION D STATE BOARD APPROVED CORRESPONDENCE PROGRAM
Instruction by the parent when the child is enrolled in an approved correspondence program. A LIST OF APPROVED CORRESPONDENCE PROGRAMS APPROVED BY THE NEVADA DEPARTMENT OF EDUCATION IS AVAILABLE IN THE HOMESCHOOLING OFFICE.
Name of approved correspondence program with enrollment verification
Nevada regulations require you to provide 180 days of instruction during the school year. You may choose any 180 days during the year from July 1st to June 30th .
July _____________ Days Nov ___________ Days Mar ____________Days
Aug _____________ Days Feb ____________Days Apr ____________Days
Sept _____________Days Dec ___________ Days May ____________Days
Oct ______________Days Jan ____________Days June ____________Days
A school day in session must consist of the following minimum daily periods for each grade, including recess and time between activities, but not including the time allowed for lunch. (NRS 387.131)
Please check the one you are using.
Kindergarten 120 minutes a day _____ 1st and 2nd 240 minutes a day _____
3rd thru 6th 300 minutes a day _____ 7th thru 12th 330 minutes a day _____
Ruturn Notification Packet IN PERSON with identification to receive letter of exemption:
Central Student Services
Home Schooling Department
2701 E. St. Lous Avenue
Las Vegas, NV 89104-4214
(702) 799-8636 x330
If student has never been enrolled in CCSD
Birth Certificate must be submitted
Make a list of textbooks, including titles and authors, as well as other books or materials that you will be using to Nevada State Standards. You may list encyclopedia sets, educational games, computer software, musical instruments, are supplies, microscope and slides, time lines, magazines subscriptions, the public library or other resources. (Parents have the right to use additional materials to teach concepts beyond the scope of state standards.)