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Stuttgart School District
Virtual Academy Application
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Email *
STUDENT'S Last Name *
STUDENT'S First Name *
STUDENT'S Middle Name *
STUDENT'S Current Address *
(Physical Address - House Number, Street, City, Zip Code)
What grade will your child be in for the 2021-2022 school year? *
(for the 2021-2022 school year)
To which campus is the STUDENT currently assigned? *
(for the 2021-2022 school year)
Did the STUDENT participate in virtual learning this school year? *
Is the STUDENT currently enrolled in the Stuttgart School District?
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PARENT/GUARDIAN Last Name *
PARENT/GUARDIAN First Name *
What is your relationship to the student? *
PARENT/GUARDIAN Phone Number *
PARENT/GUARDIAN Additional Contact Number
(if available)
PARENT/GUARDIAN Employer *
PARENT/GUARDIAN Employer PHONE NUMBER *
PARENT/GUARDIAN VALID EMAIL ADDRESS *
Please provide the name and phone number of at least two (2) people we can contact if the parent/guardian cannot be reached.
Additional Contact Person #1
Additional Contact Person #2
Does the STUDENT have access to a computer during regular school hours? *
Does the STUDENT have access to the internet during regular school hours? *
Does the STUDENT receive special services? *
If the STUDENT receives special services, please check all that apply. If not, please check NONE. *
Required
STUDENT - Why do you wish to attend the Stuttgart School District Virtual Academy? *
PARENT/GUARDIAN - Why do you believe your student will be successful in the Stuttgart School District Virtual Academy? *
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