Burnt River Online Requests

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Enroll in our Burnt River Online Program

Email *

Name

Phone number

birthdate

YYYY

Gender

Male

Female

Prefer not to say

Clear selection

Address

City

State

Zip code

Current School

Past Schools

Last Grade attended; Please attach transcripts and any documentation

Grade enrolling in

When would you like to start?

Immediately

Within the current term

Next Term

Next Year

Do you have any experience with online classes? Please explain.

Do you have access to a computer with at least 1mb of bandwidth?

Please answer the following essay questions. Describe yourself: What are your goals?

Why do you want to attend Burnt River Online? What motivated you to choose our school?

What school subjects interest you and why?

Describe how you communicate and work with teachers and other students?

Parent/Guardian Information Name

Parent/Guardian Cell Phone

Parent/Guardian Home Phone

Parent/Guardian Address (please include city, state and zip code)

Parent/Guardian email

Why do you want your child to attend Burnt River Online? What motivated you to choose our school?

What are your child's strengths and weaknesses?

If your child is accepted into the program, how do you plan on supporting them in their pursuit for education?

Please list special services your child is currently receiving or needs to receive.

If your child is under a current or pending expulsion, please explain the circumstances.

PARENT/GUARDIAN PLEASE READ THIS SECTION WITH YOUR CHILD BEFORE CHECKING EACH BOX AND SIGNING BELOW.

Burnt River School is a public charter school that provides instruction both locally and online. We are committed to the success of all of our students. Our students are provided a rigorous curriculum that allows for independent and cooperative learning with local students and online students alike. Although our online high school uses the same rigorous curriculum, it does so with new and emerging distance learning technologies to provide personalized instruction. Burnt River Online School will be able to meet the needs of an assortment of 21st century students by providing them with personal individualized instruction that focuses on skills such as self-directed learning skills, innovative technology literacy, time management and personal responsibility. Unique to Burnt River Online School is that students will be able to get face to face contact and “seat time” with our highly qualified instructors through a variety of emerging technologies. All of these elements make Burnt River Charter School an excellent choice for a high-quality education.

I understand that submission of this application does not guarantee admission to Burnt River Online Program, and that every applicant has equal opportunity to receive services if they meet the grade and age requirement.

I understand that false or misleading information on this application will result in this application not being accepted or revoked.

I understand that if more applications are received than spaces are available that a lottery will be conducted to fill the spaces as specified by Oregon Law.

I understand that all applicants will be notified by phone and mail of the applications’ status in a timely manner.

I endorse my child’s application to Burnt River with the understanding that if my child’s application is accepted I will support my child with his/her classes.

I understand that if accepted, my child (the student) will have to abide by the rules outlined in the Burnt River student handbook.

By signing this I understand that if at the end of any quarter of enrollment in Burnt River Online, name of student is not passing 5/7 classes, name of student will be removed from the program and name of students’ resident district will be notified about the enrollment change.

Signature: (Digital signature is the same as a physical signature.)

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