Student Opt-In Form
Please fill out the following form and select the learning option for your student. PLEASE FILL OUT 1 SURVEY PER STUDENT.
Selecting the ON CAMPUS OPTION: Students will attend school on campus. Students may choose to change from on campus learning to online learning at any time, but will remain in the online program until the end of the current term (at which time they can follow the process for ON CAMPUS enrollment).*
Selecting the ONLINE LEARNING OPTION: Students will complete assignments both online and packets provided by teachers. These students will not be allowed to attend classes on campus. These students agree to keep up with weekly assignments and to participate in on campus testing as scheduled. This testing will be scheduled during early out times M-Th and on Fridays. Students will be allowed to change to ON CAMPUS learning at the end of a term and by following the procedure.*
*Additional information about each option and the schools approved reopening plan can be found on our school website
on our Covid-19 Information page.
Student Name (Last, First)
Does your student identify as a high risk individual for Covid-19?
Does your student have any of the following plans?
Individualized Education Program (IEP)
Individual Healthcare Plan (IHP)
No, my student does not have any of these plans
Please choose your student's learning plan
On Campus Learning
Online Learning (selecting this option will mean your student is learning online, off campus, until the end of the term)
Please read and click the following
I understand that IF I select the ONLINE LEARNING PLAN, this choice is final and the school does not need to allow for a change until the end of the term.
Never submit passwords through Google Forms.
This form was created inside of Lakeview Academy.