West Shore School District - Online Learning (Cyber) Information Request
If you would like to find out more about our online learning (cyber) program, please complete this form and someone will contact you. NOTE: All students/parents/guardians must meet with a member our online learning staff before the registration process can begin. This form does not register your child for cyber.
Student's Last Name *
Your answer
Student's First Name *
Your answer
Parent's Last Name *
Your answer
Parent's First Name *
Your answer
Telephone Number (including area code) *
Your answer
Street Address (number, street name, apt number if applicable) *
Your answer
City *
Your answer
State (i.e. PA) *
Your answer
ZIP Code *
Your answer
School in which student is currently enrolled *
Grade Student is In *
Does your child qualify for any of the following? (check at least one) *
Required
Child's Gender
Why do you want your child to attend our online program? *
Your answer
What makes your child a good candidate for online instruction? *
Your answer
Please give an email address with which you would like us to contact you. *If your child attends a school outside West Shore School District, please list the grade they will be entering in August 2017. *
Your answer
Is there anything else you would like us to know?
Your answer
Submit
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