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Informal Geometry: Sign-Up Form
Please fill out this form for Mr. Rucker.
It is important to understand that this onsite course will expect you to attend classes regularly each week and follow scheduled deadlines. Read the course description for class expectations.
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Student Last Name
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Your answer
Student First Name
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Your answer
Student ID Number (ex: 192837)
**do not include initials, if you do not know what it is, ask your advisor or reference ParentVue
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Your answer
Student Email
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Your answer
Student Phone Number
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Your answer
Student Grade Level
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Choose
9
10
11
12
Parent Last Name
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Your answer
Parent First Name
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Your answer
Parent Email
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Your answer
Parent Phone Number
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Your answer
What HS Math credits has the student already completed? Please check all that apply
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Intro to Algebra
Algebra 1
None
Other:
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Name of Student Advisor
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Your answer
Does student have access to reliable internet to utilize the online Google Classroom platform?
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Yes
No
Other:
I have reviewed the course description on the website and understand expectations for this class.
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Yes
No
Other:
Do any of the following conditions apply to your student?
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Asthma: carries an inhaler
Anaphylaxsis "EPIpen is needed on you"
Diabetes Type 1: Insulin Dependent
504 Plan
IEP
Allergies or other food sensitivities
Other:
Required
Any additional information you would like for me to know or be aware of (expand on previous answers, Care Plan, Expected absences, concerns) ?
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