Elmore City-Pernell Distance Learning Option
Elmore City-Pernell School District will be providing families with a Distance Learning Option for the 2020-2021 school year due to the current COVID-19 pandemic. Please complete this form for every student in your household who will be participating in this option. An Elmore City-Pernell administrator will contact you to discuss your child's academic needs and provide information to answer any questions about the distance learning option.
Email address *
Student's First Name *
Student's Last Name *
Parent/Guardian First Name & Last Name *
Parent Phone Number *
Student Address *
Do you live in the Elmore City-Pernell School District? *
Grade this student will be in during the 2020-2021 school year? *
Do you have daily access to the internet? *
Does your student have a device to access distance learning? *
Does your student have any of the following? *
Provide any additional information pertinent to your student's enrollment in Elmore City-Pernell School District's Distance Learning. Feel free to address why you are considering this option and the benefits the program may provide you and your family.
Never submit passwords through Google Forms.
This form was created inside of Elmore City-Pernell Schools. Report Abuse