Appendix H

Columbia Union Conference

Education Code

Course Verification

Home-Schooled Students with Secondary Courses

Students who have taken secondary subjects in a home -school setting must have a parent and/or teacher complete this Course Verification Sheet. Instructions for completing the sheet are given on the back. Use additional sheets as needed.

Directions for Completion:	Provided below are descriptors for each requested item of information in the form. Please complete the form and provide accurate and substantive information.

Course Title:	List name or description of each home school course.

Days Taught:	Indicate total days each course was in session (i.e., If the class met five times/week for 35 weeks, the total would be 175 days).

Minutes:	Indicate the total number of minutes the class met during each week.

Grades:	Indicate the grade given for each semester.

Textbooks:	List books and/or reference materials used. Indicate title, author, date of publication, and publisher of each.

Portfolios:	If the portfolio was prepared or student work such as lesson plans, tests, homework, written projects, etc. is available, please indicate and attach to form.

____________________ Academy

Course Verification

Home-Schooled Students with Secondary Courses

Course Title

Teacher

Days Taught

Mins/ week

Grades

1st sem 2nd sem

Textbook/Reference Used

Title/Author/Date/Publisher

Portfolio and/or Related Material

Give name of affiliated Home School Association if any: _______________________________. If any of the courses listed above were taken by correspondence, attach a copy of the grades or transcript.

__________________________________________	_____________________________________

Parent Signature	Teacher Signature

This form is not an official transcript, but a listing of courses (with supporting information) taken in a home-school setting. This form is to be attached to official transcripts. Provided on the attached page are directions to assist in the completion of the course(s) verification.