eCampus Academy Student Pre-Enrollment Information Form
A Student Pre-Enrollment Information Form must be completed in its entirety for each student.  The purpose of this form is to assist eCampus staff with planning and preparation in order to provide the best possible support for our students and parents as we discuss options with you.

Submitting this form does not bind you to enroll your student.  All families who submit this form will be contacted by the eCampus office usually within 1 business day.  This form is intended for parents/caregivers to complete.

Please complete all fields.
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Student First Name *
Student Last Name *
Grade Level in 2022-23 *
Street Address *
City, State  Zip *
Language Spoken at Home *
My child is located: *
Current School *
Enrollment Information
Are you interested in enrolling for the 2022-23 school year? *
My child would like to attend: *
Have you discussed eCampus enrollment with your child's school administrator/principal or guidance counselor? *
For students not currently attending school in the WUSD:  Have you registered to attend our district? *
For high school aged students:  Are you interested in one of our Career Pathways or the Accelerated Degree Pathway?  More information can be found under Curriculum on the eCampus home page.   *
If you selected "Yes" above, which Pathway are you interested in?
Does your child receive special education services? *
Has your child been referred for special education services?   *
Is your child under expulsion from his/her current school? *
Contact Information
Parent/Guardian First Name *
Parent/Guardian Last Name *
Relationship to student *
Best phone number to reach you *
E-mail *
Preferred Way to be Contacted *
 How did you learn about eCampus? *
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