GO/GA 2020-2021 Special Request for High School Students Form
If for some reason you did not meet the deadline for requesting a Granville Online course, please use this SPECIAL REQUEST FORM to complete your request.

This form IS ACCEPTING High School Requests for the 2020--2021 School Year. If you wish to enroll in a course through Granville Online, you must completely and accurately fill out all the information in this form. Once your form has been submitted, final approval to enroll in your chosen course(s) will be obtained from your school's guidance counselor. Please note that completing this form does not mean you are enrolled in the course. You will need to communicate with your counselor.
Email *
STUDENT INFORMATION
Student LAST Name *
Student FIRST Name *
Student Middle Initial *
Student Date of Birth* *
Please use format 02/08/1981
Student Grade Level for 2020-2021 School Year
Clear selection
Student ID Number *
Student Street Address *
Student City and Zip Code *
Student Home Telephone Number *
Please use format 919-999-9999
Student Cell or Alternative Number
Please use format 919-999-9999
Student Email Address *
Please provide an email address that you check regularly. If you do not have a regular email yet, note that every student in GCS has an email address. The address is their computer username@gcsnc.us. For example: jonesp@gcsnc.us
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