TAG Program Enrollment Application Jeffco's 21st Century Virtual Academy 2018/2019
Potential students and their parent(s)/guardian must complete the required enrollment steps before finalizing enrollment in Jeffco's Virtual Academy. (Please note enrollment into Jeffco's Virtual Academy is not automatic)
I understand that filling out this survey is the first step of the application process. I understand my student's enrollment is dependent upon successful completion of the Introduction to Jeffco's Virtual Academy and that all required paperwork has been submitted and reviewed by the registrar. *
Required
I acknowledge that this application is for the TAG Program. The TAG program serves 11th and 12th graders who are off track for graduation. *
If you need middle school, full time JVA, or tuition based courses, please return to our website for the appropriate application.
Required
Student ID Number (put N/A if student is not currently in a JeffCo school) *
Your answer
Student Last Name *
Please provide student's legal last name
Your answer
Student's First Name *
Please provide legal first name
Your answer
Student's Middle Name *
Please provide full middle name
Your answer
Name of Current School *
Your answer
Student Grade Level for the 2018/2019 School Year *
Your answer
Number of credits student currently has (put N/A if unsure) *
Your answer
Student Date of Birth *
Day, Month and Year (xx-xx-xxxx)
Your answer
Name and Phone Number for your Student's Current Counselor *
Your answer
Student Email Address *
Your answer
Student Phone Number
Your answer
Parent/Guardian Name *
Please provide the following information for student's parent/guardian
Your answer
Parent Phone Number *
Your answer
Parent Email Address *
Your answer
Please Enter Parent Email Address Again *
Your answer
Relationship to Student *
Your answer
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