Yukon Virtual School K-6 Application
Please complete this application and entry survey to request full-time virtual enrollment for kindergarten-6th grade.
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Student ID *
Student First Name *
Student Last Name *
School Year 21-22 Grade Level *
School Year 21-22 Home School Site
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Date of Birth *
MM
/
DD
/
YYYY
Home Address *
Have you ever been identified to receive special services? (check all that apply.) *
Required
Primary Parent/Guardian Name *
Primary Parent/Guardian Phone Number *
Primary Parent/Guardian Email *
Parent/Guardian
Parent/Guardian Phone Number
Parent/Guardian Email *
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