Enrollment Form (2018-2019)
Filling out this survey will submit your information to our Kentwood International Virtual Academy Staff. Upon receiving your information we will begin your enrollment.
Student Name *
Please enter your first and last name.
Your answer
Email Address *
Please enter the email address you would like to be contacted at regarding this application
Your answer
Student Phone Number *
Your answer
Student Address *
Your answer
Parent/Mentor Name *
Your answer
Parent/Mentor Email Address *
Your answer
Parent Phone Number *
Your answer
Technology Access *
What technology access do you have in your home? Check each box that applies
Online Learning Experience *
Have you taken an online course before?
Technology Compentency *
Select the statement that best describes your technological compentency
Responsible Learning *
Online courses require you to be a self-motivated, independent learner. You are responsible for your progress and pacing. Select the statement that best describes you as a learner.
Communication Skills *
Successful online learners communicate often with instructors regarding pacing, content of courses, etc. Please select the statement that best describes you.
Availability *
In a given week, how much time do you expect to spend studying for one course?
I think an online class: *
Application Essay *
Please state your goals for taking an online course. Let us know why you believe an online course would be a good educational fit for you. Share any background information that you feel is important.
Your answer
Enrollment Background *
Please tell us the school district in which you are currently attending.
Your answer
Feedback *
How did you hear about KIVA? Check as many boxes that apply.
Never submit passwords through Google Forms.
This form was created inside of Kentwood Public Schools. Report Abuse - Terms of Service