Cyber Academy Application
Welcome! This is the application for Lakeland's Cyber Academy. We use Apex Learning for students to be able to complete their work at their own pace. We serve 9th-12th grade students. After we have been able to evaluate your application, we will get back to you about approval or denial to the program.
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Email *
Student's full legal name:  *
Which term(s) are you applying for? *
What is the student's current grade level? *
Home address (house/apartment number, street name, city/town, state, zip) : *
Student's best phone number: *
Parent/Guardian #1 Name: *
Parent/Guardian #1 phone number that works: *
Parent/Guardian #1 email address: *
Parent/Guardian #2 Name:
Parent/Guardian #2 phone number that works:
Parent/Guardian #2 email address:
What school does the student currently attend? *
Does the student plan to participate in after school clubs, sports, or other extracurricular activities during the school year?
*
Why does the student wish to attend Lakeland's Cyber Academy? How will they be successful taking classes online?
*
Does the student have an IEP or 504 plan? *
IF the student has an IEP, who is the Teacher of Record and what is the qualifying condition?
Please explain any attendance issues here:
Please explain any behavioral issues here:
How did you learn about Lakeland's Cyber program? *
By checking the boxes below, you are verifying that all information within this application is true and accurate: *
Required
A copy of your responses will be emailed to the address you provided.
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