2024-2025 Bears Academy Registration Contract

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By completing and submitting this form, I the Parent/Guardian of the student listed below, am confirming my child's enrollment in the Bears Academy for the 2024-2025 school year. I am also confirming that I read and understood the informational documents; Student Contract, Parent Contract, and Online Learner Profile, for myself and my child for the 2024-2025 school year.

Please note, all students in grades 9-12 must pick their electives and indicate their choices on this form as well.

Email *

Student PV Email Address *

Today's Date: *

YYYY

Student's Last Name: *

Student's First Name: *

Student's Grade Level for the 2024-2025 School Year: *

My student has accommodations through: *

504

IEP

GIEP

none of the above.

Does your student attend Monroe County Technical Institute (MCTI) *

Morning MCTI

Afternoon MCTI

Please specify your family's technology. *

We have a school issued Chromebook.

We have a computer/device at home that can be utilized for Bears Academy.

We will need technology to be supplied by the Pleasant Valley School District.

Student's Mailing Address *

Student's City *

Student's Zip Code *

Parent/Guardian(1) First Name: *

Parent/Guardian(1) Last Name: *

Parent/Guardian(1) Address (if different from student):

Parent/Guardian(1) Phone Number: This number MUST be able to receive voicemail messages. *

Parent/Guardian(1) Email Address: *

This is the primary email address where you will receive reports regarding student progress, important information, and announcements. Please type carefully.

Parent/Guardian(2) First Name:

Parent/Guardian(2) Last Name:

Parent/Guardian(2) Address (if different from student):

Parent/Guardian(2) Phone Number:

Parent/Guardian(2) Email Address:

This is the secondary email address where we will send information and announcements. Please type carefully.

My student was most recently enrolled in: *

PV Brick and Mortar school (PVE, PVI, PVMS, or PVHS)

PV Bears Academy

Out of state school

Cyber Charter (CCA, Agora, etc.)

Other

For Students grades 9-12 only, all other students please skip this question:

Please click here and select 2.5 credits worth of elective courses you would like to participate in and type them here. Additionally, if you wish to substitute any acceptable courses (for example, AP English instead of English 12), please make that request here.

Please initial to acknowledge you read and reviewed the Online Learner Profile. *

Please initial to acknowledge you have read the Student Contract and the Parent/Guardian Contract. *

Send me a copy of my responses.

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