Learner Change Form
The requested changes will be made to all primary VCA accounts assigned to the learner, parent and PM (FRED, Moodle and Power School).
Which VCA Campus is the learner currently assigned to?
Which learning path is the learner currently on?
Requested change for the following learner(s) accounts
Be sure to include each learners first and last name. This will ensure that the correct learner accounts are changed.
Your answer
Requested change for the following parent/mentor(s) accounts
Be sure to include each parent/mentors first and last name. This will ensure that the correct accounts are changed.
Your answer
New mailing address
Include street or box, city, state and zipcode
Your answer
New physical address
Include house number/street , city, state and zipcode
Your answer
New email address
Your answer
List OLD phone number that needs to be removed
Include area code with phone number (xxx) xxx-xxxx
Your answer
List NEW phone number
Include area code with phone number (xxx) xxx-xxxx
Your answer
Request to change learners assigned VCA Campus to which of the following?
Changes have to be approved by the appropriate director. The director will verify there is space available at the requested campus prior to a switch being made.
The learners primary mentor will be changed to whom? Please include a phone number for the new mentor.
The consensus group will be notified of this change and the new mentor will receive a FRED user account. The new PM will also need to complete a Contract of Agreements.
Your answer
Additional information related to change request.
Your answer
Name and relationship of person submitting change form.
An example would be John Wayne, Parent or Patty Pan, HQC
Your answer
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