Education and Early Childhood Learning

Homeschool Forms

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Homeschool Forms

If you have any questions about completing the form, please visit the Homeschooling Website for samples and guidelines.

You may also contact the Homeschooling Office at homeschooling@gov.mb.ca.

Information can only be saved upon completion of the form.

Homeschool Family

Are you homeschooling for the first time in Manitoba? Yes No

Homeschooling Family Number: (found on confirmation of notification letters previously issued)

Form Submission

Only one Student Notification Form, only one January Progress Report and only one June Progress Report, per student, per school year, are saved.

School Year:

I am Submitting: Student Notification Form January Progress Report June Progress Report

Student

Student Information

Last Name: (same as birth certificate)

Legal Given Name(s): (same as birth certificate)

Birth Date:

Grade Level: (indicate in the subject area(s) if working at a different grade level)

Please check box if student is enrolled with InformNet or TMO.

If student is enrolling in more than 5 InformNet or TMO courses for this school year, then DO NOT submit a Student Notification Form for them this year.

Gender:

Is CFS the legal guardian of this child? Yes No

Has the CFS Agency information changed since the last homeschool form submission? Yes No

CFS Agency Information

Agency Name:

Worker's First and Last Name:

Street Address/Box No.:

Province/Territory :

City/Town:

Postal Code:

Phone Number: Email:

Confirm Email Address:

Progress Report

For samples and guidelines, please visit the Homeschooling Website. A percentage or letter grade is optional.

If more space is needed, see Supporting Documentation section below.

Language Arts

Mathematics

Science

Social Studies

Other

Program Outline

Homeschool parents research, choose, and acquire the materials and resources to support programming in each subject area. When developing a program of studies and setting learning goals, consider your child's interests, skills, and abilities.

For each subject area, include the title and grade level of chosen resources, programs and materials selected. You may also include topics, concepts, and units of study.

If more space is needed, see Supporting Documentation section below.

For samples, guidelines and examples of program outline content, please visit the Homeschooling Website.

If more space is needed, see Supporting Documentation section below.

Language Arts

Mathematics

Science

Social Studies

Other

Language of Instruction:

DSFM Student

Supporting Documentation

I would like to attach supporting documentation: Yes No

Supporting documents must be in a .jpeg format, clear and readable, and less than 3MB each. A maximum of three .jpegs (pictures) can be submitted per form.

If you experience issues attaching supporting documentation, please contact the Homeschooling Office at homeschooling@gov.mb.ca.

Additional Comments and Questions

Declaration

Legal Statement

As parent/guardian who will be providing homeschool programming, I:

affirm that I will abide by the requirements of The Public Schools Act and that I will work with the Homeschooling Office to ensure legislative requirements for homeschooling are being met.

accept the responsibility for planning program outlines, providing instruction, reporting progress, assuming costs, as well as meeting requirements for my child's future employment or post-secondary entrance.

affirm that all parents that have legal authority to make educational decisions for my child and legal guardians (if applicable) of my child have reviewed the program outline, are in agreement with homeschooling and are included in the parent/guardian information section on this form.
NOTE: This includes (but is not limited to) parents with a court order (indicating shared custody or educational decision-making authority), parents with no court order, or a social worker with Child and Family Services.

affirm that the information submitted on this form and in attached documents is correct and any updates or changes to this information will be provided to remain current.

understand that the Homeschooling Office is authorized to collect the information on this form under s. 36(1)(b) and (c) of The Freedom of Information and Protection of Privacy Act (C.C.S.M. c. F175), s. 13(1) of The Personal Health Information Act, The Public Schools Act (C.C.S.M. c. P205) and The Education Administration Act (C.S.S.M. c. E10). All information I submit on this form is protected by the Protection of Privacy provisions of The Freedom of Information and Protection of Privacy Act and, in the case of personal health information, the provisions of The Personal Health Information Act. If you have questions about the collection of information, please contact the Coordinator at the Homeschooling Office, by phone at 204-945-8138 or by email at homeschooling@gov.mb.ca.

Declared By: (type your first and last name) Date:

Click the PRINT/SAVE button to keep a copy of this form before clicking SUBMIT. Families are encouraged to keep their own homeschool records.

Click SUBMIT to send the report to the Homeschool Office. A new screen will appear with the submission reference number.

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Homeschool Forms

Homeschool Forms

Homeschool Family

Form Submission

Parent/Guardian Information

First Parent/Guardian

Second Parent/Guardian

Main Instructor

Student

Student Information

CFS Agency Information

Progress Report

Program Outline

Supporting Documentation

Additional Comments and Questions

Declaration

Legal Statement