Resident School District:  Pomeroy School District #110

ESD/County: Educational Service District 123/Garfield

A parent who intends to cause his/her child or children to receive home-based instruction in lieu of 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 the intent to do so in the format prescribed below:

I do herby declare that I am the parent, guardian, or legal custodian of the child(ren) listed below; that said child(ren) is(are) between the ages of 8 and 18 and as such are subject to the requirements found in Chapter 28A.225 RCW Compulsory Attendance; I intend to cause said child(ren) to receive home-based instruction as specified in RCW 28A.225.010(4); and if a certified person will be supervising the instruction, I have indicated this below.

This must be completed/filed annually by September 15th 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.