Holly Springs School District Distance Learning
The purpose of this form is to permit a parent or guardian to register intent for their child to enroll as a full-time distance learning (virtual) student(s) in the Holly Springs School District for the first nine weeks of the school year 2020-2021. This registering is in addition to and does not replace the online registration process for the actual school in which student(s) enrolled. Please complete one (1) form for every student you want to register for full-time distance learning.
1. As the parent or guardian of the student named in this form, I am choosing the following option for the first nine-weeks of the 2020-2021 school year. I have read the document "HSSD - Comprehensive Reopening Plan" (on the district website
) and understand the limitations and restrictions this choice imposes.
Virtual Learning Program
Hybrid Model (face to face and virtual)
2. Student's Last Name (Legal name as it shows in school enrollment)
3. Student's First Name (Legal name as it shows in the school enrollment)
4. Student's Grade Level for 2020-2021
5. Student's Home School for 2020-2021
Holly Springs Primary School
Holly Springs Intermediate School
Holly Springs Junior High School
Holly Springs High School
6. Full Name of Parent or Guardian Completing this form. (Last, First)
7. Email Address of parent or guardian completing this form (please make sure this is a valid email address and one you check regularly).
8. Do you have reliable access to the internet at home, and do you plan to maintain that access through the 2020-2021 school year?
9. If you choose the virtual learning option, do you have a device?
Yes, I have a device
No, I need a Chromebook
No applicable my child will participate in face to face
10. Please describe the reason you are requesting Distance Learning (virtual) for your child for the first nine weeks.
11. If you choose to enroll your child in virtual (distance learning) will you need your child/children to receive lunch?
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This form was created inside of Holly Springs School District.