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Lexington Three VIP Registration Form
You will need to complete a separate application for each child that will need to be enrolled in the Virtual Instruction Program. Application is due by August 3rd in order to properly schedule each student.
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* Indicates required question
First Name of Child (Legal Name)/Nombre Del niño (nombre legal)
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Your answer
Last Name of Child (Legal Name)/Apellido del niño (nombre legal)
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Your answer
First Name of Legal Parent/Guardian/ Nombre del padre / tutor legal
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Your answer
Last Name of Legal Parent/Guardian/Apellido legal padre / tutor
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Your answer
Parent/Guardian CELL Phone Number/del padre / tutor del número de células deteléfono
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Your answer
Parent/Guardian CELL Phone Number #2/del padre / tutor CELULAR número # 2
Your answer
Parent/Guardian Email Address
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Your answer
Which school is this child scheduled to attend during the 2020-2021 school year?/¿Quéescuela este hijo asista durante el año escolar 2020-2021?
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Batesburg Leesville Primary School
Batesburg Leesville Elementary School
Batesburg Leesville Middle School
Batesburg Leesville High School
Which grade level will this child be in for the 2020-2021 school year?/¿Qué gradoescolar tendrá este niño? estar en el año escolar 2020-2021?
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Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Does you child receive special special services (IEP, 504, ESOL) through Lexington Three?
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Yes
No
Do you have reliable WiFi access available throughout the entire semester?
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Yes
No
Typing your FULL NAME in the box below indicates you understand and agree to the requirements for the Lexington Three Virtual Instruction Program for 2020-21.
*
Your answer
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