Rogers Virtual Learning Application
Please complete the virtual learning application below. Once accepted you will need to enroll in Rogers Public Schools and provide all needed documentation i.e. Birth Certificate, Immunization Records, etc.
**Completing this application does not mean acceptance into virtual learning. A face to face meeting will be scheduled with the virtual director to assess the student's ability to be successful in a virtual environment.
Students Last Name *
Your answer
Students First Name *
Your answer
Student ID (RPS Students only)
Your answer
Current Grade *
Current Credits *
Your answer
Birthdate *
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Age *
Your answer
Phone Number (555) 555-5555 *
Your answer
Address *
Your answer
Parent/Guardian Name *
Your answer
Email address *
Your answer
School Making Referral (use homeschool if you are a homeschool student) *
Your answer
Name of Person Making Referral *
Your answer
Reason for Referral *
Your answer
Description of parent/guardian’s involvement with the student to serve as learning coach *
Your answer
Does the student have reliable internet service and a computer at their home?
Does the zoned school of the student have enrollment documentation on file? *
Does the student currently receive services through Special Education Department, or has the student ever received services in the past? If yes, please provide a copy of the current IEP *
Does the student currently receive 504 services? *
In a well-written paragraph, please discuss why you (the student applicant) want to attend Rogers Virtual Learning. *
Your answer
When you are ready to submit, please contact Darla Tomasko via email at darla.tomasko@rpsar.net to notify RVL that your application has been submitted. Feel free to put any questions/comments in the box below.
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