Individualized home instruction plan sample 2025

1. Click ‘Get Form’ to open the individualized home instruction plan sample in the editor.
2. Begin by filling out the 'Child’s Information' section. Enter the last name, first name, date of birth, and grade level for the school year 2019-20. If known, include the 9-digit NYC Student ID number.
3. Next, complete the 'Parent’s Information' section. Provide your last name, first name, home address (including apartment number), city, state (NY), zip code, home telephone number, alternate telephone number, and email address.
4. In the 'Subjects' section, list all subjects you plan to cover. Ensure you include required subjects such as Arithmetic, Reading, and Science. You may also attach syllabi or curriculum materials if necessary.
5. Indicate the dates for quarterly report submissions in the designated area. Make sure these dates align with your instructional period.
6. Finally, provide names of individuals who will be providing instruction and ensure that parents or legal guardians sign where indicated.

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