K-12 Virtual Online Instruction Registration Form
This registration form indicates your interest in attending school through the virtual online option during SY20-21 instead of in-person instruction. In addition to this form, you must also complete the regular enrollment/registration process for your school. Participation in a parent orientation is also required for parents of K-8 students opting for virtual online instruction. Additional information and eligibility requirements will be provided at the orientation. If you have multiple children in grades K-12 who will be attending school with virtual online instruction, please complete separate registration forms for each child.
Student Full Name *
School *
Grade Level for SY20-21 *
Student Date of Birth (MM/DD/YYYY) *
Student Lunch Number (5-digit) *
Parent/Guardian 1 Full Name *
Parent/Guardian 1 Home Address *
Parent/Guardian 1 Phone Number *
Parent/Guardian 2 Full Name
Parent/Guardian 2 Home Address
Parent/Guardian 2 Phone Number
Technology Information: Please mark the appropriate box to provide computer information for your household. *
Technology Information: Please mark the appropriate box to provide internet access information for your household. *
Please read the statements below and mark beside each to acknowledge these conditions. *
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