Request edit access
Estill County School District Virtual Academy- Grades K-5 Application.  Please complete this form for all applicants incoming Kindergarten - 5th graders. Please complete one form per child. This application for enrollment is for the 2025-2026 school year.  
Sign in to Google to save your progress. Learn more
Email *
Student Name *
Parent/Guardian Name(s) *
Parent/Guardian Email Address *
Parent/Guardian Phone Number *
Student Residential Street Address: *
City of Residence, State and Postal Code: *
Student Current Graded Level: *
Student's Date of Birth: *
MM
/
DD
/
YYYY
Is the student currently enrolled in the Estill County School District? *
What school is the student currently enrolled in? If enrolled outside of Estill County please provide the location (District and City). *
Does your student receive IEP (Individual Education Program), a 504 Plan or Special Education Services? You can share any needs that you think are important prior to an intake meeting. *
Do you have daily, dedicated high speed, reliable internet?  This includes, DSL, Cable, Satellite, or non-cell phone hotspot access. *
Who is your internet service provider and what is your capable download speed? (Check your speed at www.speedtest.net) *
If you know your student's attendance record from the previous year please describe here.  *
Describe student behavior concerns you feel important for our staff to know about in this section. *
In a short paragraph, explain why your student is best suited for the Virtual Academy.  *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Estill County Board of Education.

Does this form look suspicious? Report

Google Forms