Harrisburg Virtual Learning Academy (HVLA) Enrollment Form
Thank you for your interest in Harrisburg’s Cyber Program. Please complete the enrollment form in its entirety.
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Email *
Today's Date: *
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Parent/Guardian Name (s): *
Parent/Guardian Phone Number: *
Parent Email: (*please note most of our communication is via email) *
Language Spoken: *
Current Home Address: *
Emergency Contact: (name & phone number) *
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