WCSD Virtual/Online Participation Request Form - Dexter
Please complete this form only if you are requesting participation in the virtual/online option for instructional delivery. As a parent/guardian, you will be responsible for co-facilitating, along with a WCSD teacher, your child's education at home. This participation request is for a full term (nine weeks) in which it is requested. You child cannot return to the traditional classroom until the end of the term in which they are virtually enrolled. You will need to submit this form for each child you are requesting to participate in the virtual/online option.

Participation requests are due by: July 31, 2020
Student Legal First Name: *
Student Legal Last Name: *
Student's Date of Birth *
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What school will your child attend for the 2020-2021 school year? *
Please select your child’s grade level. *
Parent/Guardian Name: *
Phone Number: *
Email address: *
Physical Address: *
Do you have a device (laptop, computer, chromebook etc.) for your child to use at home? *
Do you need a district-issued chromebook for your student to participate in virtual/online learning? *
Do you currently have sufficient/reliable internet access at home that you will have for the 2020-2021 school year? *
If your answer is no, will you be able to access it at another location (ex: school parking lot, a relative's home, etc.)? *
My child has a IEP or 504 plan . *
Please indicate the reason(s) you are choosing to opt out of the traditional return to school. *
Required
Participation Request Agreement
I understand and agree with the Parent Request Agreement form above. *
Parent/Guardian Digital Signature: *
Today's Date: *
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Submit
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