Bay District
Schools
Division of Teaching and Learning
INTENT TO
TERMINATE HOME SCHOOL ENROLLMENT
Printable Intent to Terminate Form
Dear Superintendent:
I am terminating my child’s Home School enrollment in Bay County, Florida. I will enroll my student within 3 days in a public, private, or virtual school in accordance with Florida Statute 1003.21.
Student’s Name: ______________________ Date of Birth: _____________________________
Termination Date:
_____________________ Current Grade:
____________________________
Check the reason for termination of
Home School below (only one):
_____ My child has been or will be
enrolled in _________________________________________
_____ My child has reached the age of
sixteen (16) and is no longer compulsory school age.
_____ My child will no longer reside in Bay County,
Florida.
New residing county and/or state will be: ________________________________________
Other: ____________________________________________________________________
_________________________________________________________________________
__________________________________________________________________________
_________________________________________ ________________________
Parent/Guardian
Signature Date
Return to:
Bay District Schools Home Education Department
Attn: Homeschool
1311 Balboa Ave,
Panama City, FL 32401
homeschool@bay.k12.fl.us
(850) 767- 4122