GULF COAST COMMUNITY COLLEGE HOME SCHOOL AFFIDAVIT by tas62516

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									                                 GULF COAST COMMUNITY COLLEGE
                                       HOME SCHOOL AFFIDAVIT
    PLEASE NOTE: THIS FORM MUST BE COMPLETED AFTER STUDENT HAS FULFILLED REQUIREMENTS FOR GRADUATION.



I __________________________________, hereby certify that ___________________________________
        (Print Parent/Guardian Name)                                                (Print Student Name)

has met the following requirements for satisfactory completion of a Home school Program:
    1. That the undersigned gives this affidavit as a part of a request to have the student admitted to
       Gulf Coast Community College.
    2. That the undersigned has educated the student in a home school program in full compliance
       with all Florida laws including, but not limited to, Florida Statue 1002.41.
       FOR FULL STATUE: www.flsenate.gov/statues
    3. That the undersigned acknowledges that this affidavit is given under oath and understands the
       penalty for perjury or false statements.
    4. ATTACH COMPLIANCE LETTER OF ENROLLMENT FROM SCHOOL DISTRICTS HOME EDUCATION OFFICE.

Date requirements for high school graduation were completed on: Mo.____Day____ Yr.____

          SECTION BELOW MUST BE COMPLETED IN THE PRESENCE OF A NOTARY PUBLIC

                        STUDENT                                              PARENT/GUARDIAN

_____________________________ Date:________               ______________________________ Date:________
              (Signature)                                                 (Signature)

NOTARY PUBLIC:                                            NOTARY PUBLIC:

The foregoing instrument was acknowledged before          The foregoing instrument was acknowledged before

me on this______ day of _________________, 20_______ ,    me on this______ day of __________________, 20_______,

by________________________________, the student, who      by _______________________________, the parent/

has produced a drivers license as identification or       guardian, who has produced a drivers license as

___________________________________ as identification,    identification or________________________________ as

and who did sign this affidavit under oath.               identification, and who did sign this affidavit under
                                                          oath.

____________________________________________________      ____________________________________________________
                   Notary Name (Printed)                                       Notary Name (Printed)

                                                          _________________________________________________________________
____________________________________________________
                                                                                 Notary Signature
                    Notary Signature


Commission Expires on:______________________________      Commission Expires on:______________________________


{stamp/seal}                                              {stamp/seal}
                                                      10/7/09 dn/aw

								
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