JVA Credit Recovery - 2018/2019
Students will not be enrolled in courses without payment. Please contact your home school for school grants as soon as possible. Jeffco Virtual does not offer any grants. *
Required
I understand that filling out this form is the first step of the application process. I understand my student's enrollment is dependent upon all required paperwork and steps being completed and reviewed by the JVA office. *
Required
Student's ID number *
Your answer
Student's Last Name: *
As it appears in Campus
Your answer
Student's First Name: *
As it appears in Campus
Your answer
Current Grade Level of Student (for 2018-2019 School Year): *
Required
Current School: *
Other School
If your school is not in the list above, please type it below.
Your answer
Student Email Address *
Student's Jeffco Schools Email (id#@jeffcoschools.us). Jeffco Gmail will be the primary method of communication for this program.
Your answer
Select up to 2 courses the student needs to makeup. Your counselor will confirm the selected courses and verify which semester is needed. *
Choose no more than 2 classes
Required
Parent /Guardian's Name *
Please provide the following information about the student's parent/guardian
Your answer
Phone Number: *
Your answer
Parent Email Address: *
Your answer
Verify the Parent Email Address: *
Your answer
Is the student a resident of Colorado: *
Required
Relationship to Student: *
Your answer
Student Date of Birth (MM/DD/YYYY) *
Your answer
Does the student have any of the following educational services? Select all that apply. *
Required
Statement of Education Equality
Jeffco's Virtual Academy is committed to a policy of education equality. Accordingly, the program admits students and conducts all educational programs, activities, and employment practices without regard to race, color, religion, gender, sexual preference, national origin, marital status, ancestry, disability, or any other legally protected classification. Any person having inquiries concerning the school's compliance with Title IX of the Educational Amendment of 1972, Section 504 of the Rehabilitation Act, the Americans with Disabilities Act, or the Individuals with Disabilities Education Act, or who is disabled and needs special accommodations to participate is directed to call our office at 303-982-6770.
I understand that I must demonstrate consistent student progress on a weekly basis, an expected part of my Jeffco Virtual Academy course work. If I do not show weekly progress, I understand I may be removed from the course by JVA staff and will not receive a refund. *
Required
I understand that I must contact the staff of Jeffco Virtual Academy when I am experiencing learning, instructional, or technical issues. *
Required
I understand that it is my responsibility to secure both a computer and an Internet service provider in order to ensure consistent access to the online classes. *
Required
I understand that I must inform my home high school counselor that I have applied for Fall 2018 Credit Recovery at JVA and ask my counselor to complete the online Counselor Verification Form to approve the course(s) I need to take. *
Students will not be scheduled until the Counselor Verification Form is completed by the home high school counselor.
Required
Please accept this signed and completed Enrollment Acceptance form to enroll in Jeffco's Virtual Academy Credit Recovery program for Fall 2018.
Student Use of the Internet
In order to provide for the appropriate use of the Internet in accordance with district policy JS, "Student Use of the Internet", and other applicable district policies, the following "Acceptable Use Agreement" has been developed. A copy of this agreement will be distributed to students and must be completed and signed by the student and the student's parent/legal guardian before a student is allowed to access district computing resources. Acceptable Use Agreement for Students~ All computers having Internet access must be used in a responsible, efficient, ethical and legal manner. Failure to adhere to district policy JS, Student Use of the Internet," will result in revocation of access privileges; restitution for costs associated with damages; and, may result in disciplinary action as indicated in the paragraphs below, and/or legal action. I have read and understand district policy JS, "Student Use of the Internet," and agree to abide by its terms. I further understand that violation of district policy JS,"Student use of the Internet," may result in loss of Internet access and/or computer use privileges, and school discipline (including suspension or expulsion) being taken against me, legal action being taken against me, and/or restitution by me for costs associated with any damages caused by such violations.
Student's Signature *
Student's should enter full name below as electronic signature
Your answer
Parent or Guardian
As the parent or legal guardian of the above student, I give my consent to his/her use of school computers to access the Internet for school-related academic purposes while at school under the terms and conditions set forth above. All students regardless of age must have this contract signed by a parent/guardian in order to access the Internet at school.
Parent/guardian Signature *
Responsible party should enter full name below as electronic signature
Your answer
Thank You
Thank you for completing the application form. COMPLETING AND SUBMITTING THIS ONLINE APPLICATION DOES NOT CONSTITUTE ENROLLMENT IN JEFFCO VIRTUAL ACADEMY. You will be contacted soon via email by a JVA staff member who will provide enrollment availability and help you move towards completing your acceptance.
Gather and submit the documents needed to complete the application process. The Virtual Academy is unable to determine your child's eligibility for enrollment until all documentation is received.
We recommend you read the, "For Parents" page and "FAQ" page on our website to get more details about the Virtual Academy.
If you need additional assistance, call 303-982-6770, or email Terrie.Sklenar@jeffco.k12.co.us or Cori.mustin@jeffco.k12.co.us
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