NC Division of Non-Public Education 1309 Mail Service Center Raleigh, NC 27699-1309 Telephone: (919) 733-4276 www.ncdnpe.org
HOME SCHOOL ATTENDANCE RECORD -- SCHOOL TERM ____________ - ____________
County ____________________________ School Name ____________________________________________________________________________________
Name of Student _______________________________________________________________________________________________________________________
DIRECTIONS: SAVE THIS FORM AS A MASTER; make photocopies so that a separate form can be used for each student. Keep completed form(s) on file at your school for later inspection.
Please check (√) dates below on which academic instruction and educational activities were conducted.
JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL
MAY
JUNE
By my signature below, I affirm that the above entered information, to the best of my knowledge, is accurate and truthful.
Chief Administrator ______________________________________________________ Date ___________________