Madison County Virtual Academy Application 2019-2020
The student must fill out the MCVA application.
Email address *
Name: Last, First, Middle *
Base School *
Grade for 2019-2020 *
Gender *
Race *
Address *
Student Cell Phone Number *
Student Email (put the email you check daily) *
Parent's Name: List the parent(s) that has custody. *
Parent's Email *
Parent's Cell Number(s) *
Do you receive Special Education Services or have a 504 Plan? *
Why do you want to enroll in the virtual program? *
What are your future plans after high school? *
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