Elementary Evaluator Listing Request – Mason Dixon Homeschoolers Association

Please list the county/counties in Pennsylvania where you evaluate students. *

Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Your address will NOT be included in your contact information. This is for MDHSA's use only.

Phone number *

Please indicate whether you prefer texts or calls at this number. If you accept both at this number, write "calls/texts."

Evaluator Qualifications: Check one of the boxes below to indicate which criteria required by the PA Home Education Law you meet to qualify as a homeschool evaluator of elementary students. *

Licensed clinical psychologist or certified school psychologist
PA certified public school teacher or administrator with 2 years of elementary (K-6th) grading experience in any of the following subjects: English, to include spelling, reading and writing; arithmetic; science; geography; history of the United States and Pennsylvania; and civics.
Nonpublic (private) school teacher or administrator with 2 years of elementary (K-6th) teaching and grading experience in a PA public or nonpublic school in the past 10 years in any of the following subjects: English, to include spelling, reading and writing; arithmetic; science; geography; history of the United States and Pennsylvania; and civics.
Individual with other qualifications (than those listed in the home education law) who has received prior consent of the district residence superintendent to evaluate secondary students.

I understand by checking one of the above boxes that I certify and affirm that I possess the necessary credentials and/or meet the criteria set forth in the PA Home Education Law to evaluate homeschooled students. I also understand that a family may request proof of my qualifications when consulting me as an evaluator.

If you are an evaluator with other qualifications who has received prior consent of a shool district superintendent to evaluate elementary students, please list the name(s) of the school district(s) in which you have been approved as an evaluator. *

If you are qualified to pre-approve objectives for students with IEPs and wish that information to be added to your contact information, please check the box below.

Yes, I am qualified to pre-approve objectives for students with IEPs.

If you would like your contact information to include a notice that you offer virtual evaluations, please check the box below.

Yes, I offer virtual evaluations.

If you can evaluate elementary through 8th grade or if you evaluate only certain elementary grades, please list that information here.

Please know that even if you have approval to evaluate high students, it will be be shown on the elementary evaluator listing since MDHSA requires all high school evaluators to be approved MDHSA Diploma Program evaluators. See the Diploma Program website for more details.

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