Revised 10/2003                                                                                                                                                                                      Valid For One Year

 

Louisiana Department of Education

Non-Approved Registration Form

In Accordance with R.S. 17:221.3, 17:232.C and D, and 17:236

 

Pursuant to R.S. 17:232.C. Non-approved private schools must notify the Louisiana Department of Education of the school’s existence as of the 30th day of their school term or session.

 

Pursuant to R.S. 17:232.D. It is mandated that each school in the state of Louisiana, both public and nonpublic, upon the request of the city or parish public school system within which the school is located, report whether any individual student is enrolled in such school and whether such pupil is fulfilling the compulsory attendance requirements provided under R.S. 17:221.  

 

Instructions

Please print or type the information and return both the original and a copy.

 

 

_____________________________

Name of School Representative 

_____________________________

Street Address/P.O. Box

___________________________     ________________ 

City, State, Zip Code                                  Parish

(_____)______________________

Telephone

            School Year _______________

 

Total Enrollment _______    

 

 

 

 

 

 

IMPORTANT NOTICE:  Students enrolled in a Non-approved private schools are not eligible for the Tuition Opportunity Program for Students (TOPS).

 

Name of School: __________________________________________

(Optional)

 

I hereby certify that written notification(s) of enrollment for every student who attended a public school immediately prior to his/her enrollment in this non-approved private school, including students who attended public schools at the end of the previous school year, has (have) been provided to said public school(s) in accordance with R.S. 17:221.3; that, pursuant to R.S. 17:236, the  school operates a minimum session of not less than one hundred and eighty days.

 

___________      ________________________________________                                                                  

(DATE)                          Signature of School Representative                                                        

 

PLEASE RETURN APPLICATION TO:

ATTN: Home Study Program

Louisiana Department of Education

P.O. Box 94064

Baton Rouge, Louisiana 70804