2020-2021 Chestnut Ridge Virtual Academy Student Application K-4
Student First Name *
Student Last Name *
Are you currently enrolled in the Chestnut Ridge School District
Clear selection
If you answered no to the previous question, what school district are you currently enrolled in
Student ID#
This is also you lunch #
Grade Level for 2020-2021 School Year
Does the student have an IEP (Individualized Education Program)
Clear selection
Please indicate your registration status
Clear selection
Do you have high speed internet access at home?
Clear selection
Would you be in need of a district issued laptop?
Clear selection
Is a parent or guardian at home throughout the school day?
Clear selection
Parent/ Guardian Contact Information
Primary Parent/Guardian Full Name *
Primary Parent/Guardian Home Phone *
Primary Parent/Guardian Cell Number *
Primary Parent/Guardian Email *
Electronic Signing
Student Signature- acknowledges that you have read and will abide by the terms as outlined on the district website. *
Required
Parent/Guardian Signature- acknowledges that you have read and will abide by the terms as outlined on the district website. *
Required
Submit
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