Please complete and submit the form FOR EACH CHILD IN THE HOME who will be attending East End School District for the 2021-2022 school year.
We are beginning to make plans for the 2021-2022 school year. In order to proceed with our planning, we need an accurate count on the number of students whose parents wish to commit to virtual instruction for the 2021-2022 school year, if it is offered. We want to emphasize that virtual instruction requires a strong commitment from both parents and students as well as has strict polices regarding expectations and requirements to remain in virtual learning. Please complete one form per student.
* Required
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Student's Current Grade Level
*
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
What is the relationship of the person completing this form to the student?
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Parent
Legal Guardian
Other
Guardian's Last Name
*
Your answer
Guardian's First Name
*
Your answer
Phone Number
*
Your answer
Mailing Address
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Your answer
Email Address
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Your answer
If the option is available, I would like for my student to receive instruction virtually for the school year 2021-2022 (Virtual instruction will be provided by a third party not employed by EESD):
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Yes, I want my child to attend virtually next year.
No, I do not want my child to attend virtually next year.
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