Collinsville Virtual Academy (CVA) Student Application (Jan - May 2024, Semester 2)
Thank you for completing the CVA Application. Please make sure your student completed their course requests in their Wengage Student Portal.  Schedules will be available in January. Students will need to check their school email for updates from the CVA Instructor and/or their counselor.
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Email *
1. Student Name *
2. Student Collinsville Public School Email *
3. I am applying for:  (Administrative Approval for Core Classes Required) *
4. Grade Level for the 2023-24 School Year *
5. Address (Student must reside in the Collinsville School District or currently enrolled as a student in Collinsville Schools.) *
6. Parent/Guardian Name *
7. Parent/Guardian Contact Number & Email *
11. Mark any that might apply to you: *
12. If you checked Blended above, please list the classes you are requesting to take online.
13. What questions do you have, if any?
14. What challenges do you see with your enrollment in the program? *
15. Please check each box to acknowledge your agreement with each of the following statements. I understand that: *
Student Signature & Date *
Parent/Guardian Signature & Date *
A copy of your responses will be emailed to the address you provided.
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