Request edit access
Columbus Virtual Pathway Application 2018-2019
PLEASE USE THE FOLLOWING FORM TO APPLY FOR THE 2019-2020 SCHOOL YEAR
This confidential application must be completed to enroll in BCSC's Columbus Virtual Pathway.  Completion of the application does not obligate the student to attend the Columbus Virtual Pathway, nor does it guarantee admission.  
As of August 28th we are FULL, and a wait list has been started.  
Sign in to Google to save your progress. Learn more
Student First Name *
Student Last Name *
Grade for 2018-2019 School Year *
Current School *
If you selected "Other", please list the name of the school here:
Parent/Guardian Names *
Street Address *
City *
State *
Zip Code *
Primary Phone Contact
Other Phone Contact *
Parent/Guardian Email Address (Enter N/A if you do not have an email address) *
Student Email Address (Enter N/A if you do not have an email address *
Gender *
Does (or will) your student qualify for free OR reduced lunch prices?   *
Does (or will) your student receive special education services (has an IEP)? *
Does (or will) your student receive English as a Second Language services? *
Why do you feel an online pathway is the best learning environment for this student?   *
Clicking "SUBMIT" at the end of this form will complete the application.  
If you have any questions, please feel free to contact Angie Wieneke:
Cell:  812-350-6810
Email:  wienekea@bcsc.k12.in.us
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Bartholomew Consolidated School Corporation.

Does this form look suspicious? Report

Google Forms