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.
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