Request a Learning Option Change
The purpose of this form is to request a change in the student's current learning option.
Student Legal Full Name (First Name, Middle Name, Last Name):
Student's ID Registration Number # :
Student's Year Level:
Student's Date of Birth:
Campus of Enrollment - School you are enrolled in
Requesting to change to the following Learning Option:
Option 1: Safety First In-Person - For families who want their student to have as much on-campus, in-person instruction as allowed by health conditions in the area.
Option 2: Empowered Learning At-Home - For families who wish for their student to learn online at home throughout the school year.
Reason for the Change - Reason for change:
Will this student need transportation?:
Name of parent / guardian completing this form:
Contact Phone Number:
A copy of your responses will be emailed to the address you provided.
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This form was created inside of St. Mary's Group of Schools.