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Nekoosa Virtual/Online Learning Interest
Thank you for your interest in Nekoosa's Virtual/Online Learning Program. Please take time to complete the below survey. If you are interested in learning in your home environment and have selected that option in the below survey, someone from the District will be contacting you to set up an appointment. If you are registering for an online class, the guidance office will be contacting you for further discussion. Thanks in advance for your patience as we work to develop our Virtual/Online Program.
Date *
Your answer
School year which you are applying? *
Enrollment Term *
Name of student applying for online class or virtual schooling *
Your answer
Date of Birth *
Your answer
Gender *
Required
Parent/Guardian Name *
Your answer
Current Address *
Your answer
Contact Phone Number *
Your answer
Contact email *
Your answer
Grade of student during chosen school year? *
Your answer
Seeking to enroll...... *
Are you seeking to enroll as a blended virtual student (part virtual, part on campus)? *
I am interested in participating in co-curricular activities *
Required
If you said yes to a co-curricular activity, which activities would you like to participate in?
Your answer
I have special learning needs and my learning is guided by an IEP (Special Education Individual Learning Plan). *
If you have special learning needs, please describe your special learning needs below.
Your answer
I am self-motivated and self-disciplined. *
No
Yes
I am able to direct my own learning. *
No
Yes
I know what it means to fulfill course requirements. *
No
Yes
I am all about achieving individual academic success. *
No
Yes
If I set my sights on an end result, I usually achieve it. *
No
Yes
I possess personal skills and aptitudes for online learning. *
No
Yes
I am confident in my academic abilities. *
No
Yes
I am willing to try something new. *
No
Yes
I work well in a loosely structured environment. *
No
Yes
I possess working knowledge of email. *
No
Yes
I know how to use the internet. *
No
Yes
I have basic keyboarding and word processing skills. *
No
Yes
I have convenient and frequent access to a computer with an internet connection. *
No
Yes
I am able to organize and plan my own "best time to learn". *
No
Yes
I will maintain a calendar to organize my pacing for my class or classes. *
No
Yes
I have the ability to "converse" via discussion boards. *
No
Yes
I am capable of writing to communicate ideas and complete assignments. *
No
Yes
I will inform instructors of concerns or problems. *
No
Yes
I will communicate with peers. *
No
Yes
I can read analytically and critically. *
No
Yes
I have a strong desire to learn and achieve knowledge and skills via online courses. *
No
Yes
I give up easily when confronted with tough obstacles. *
No
Yes
I believe I am responsible for my own education. *
No
Yes
I do not have conflicts with work, athletics, child care, or school activities. *
No
Yes
Other things the District should know about me are..........
Your answer
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