Nevada

NOTICE OF INTENT TO HOMESCHOOL (NRS 388D.020 — file with the superintendent of schools of the district in which the child resides; the Department of Education's standard form carries the same contents) Child's full name: [CHILD'S FULL NAME] Child's age: [AGE] Child's gender: [GENDER] Name and address of each parent filing this notice: [PARENT NAME(S) AND ADDRESS] Educational plan (NRS 388D.050): The child will be instructed in English language arts, mathematics, science and social studies, including history, geography, economics and government, as appropriate for the age and level of skill of the child as determined by the parent. [ATTACH OR STATE THE PLAN IN THE FAMILY'S OWN WORDS.] Public school in this State most recently attended (if applicable): [SCHOOL NAME, or "Not applicable"] Statement (to be signed and dated by each parent filing): I declare that I have control or charge of the child and the legal right to direct the education of the child, and I assume full responsibility for the education of the child while the child is being homeschooled. [Optional statement (NRS 388D.020(5)(f)): I expressly prohibit the release of any information contained in this document, including, without limitation, directory information as defined in 20 U.S.C. § 1232g(a)(5)(A), without my prior written consent.] Signature of parent: ______________________________ Date: [DATE] Signature of parent: ______________________________ Date: [DATE]