2021-22 Remote Learning Application
Please fill out the form below to request remote learning for the 2021-22 school year. The Remote Learning option is available for grades 3-12. If you are a parent of a student in grades K, 1, & 2, you may fill out this form, but please call Dr. Johnson at 330-866-9225.
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Student Last Name *
Student First Name *
Student's grade level for the 2021-22 school year *
Parent Last Name *
Parent First Name *
Parent Email Address *
Student Email Address *
Parent Mobile Phone Number (The Remote Learning teacher may need to contact you regarding expectations, progress, etc.) *
Mailing Address *
Check one of the following two options for applying for remote learning: *
Please briefly explain the option you chose here: *
In anticipation of staffing needs, are there any special services that your child requires?  Please note, depending on the nature of your student's needs, remote learning may not be able to service the need(s) virtually to the extent the district would be able to do so in person. *
Check the box below agreeing that you understand there may be in-person events that you and/or your child may have to attend including but not limited to testing, orientation, and picking up/dropping off supplies including technology repairs.  Whenever possible, advanced notice will be given. *
Check the box below agreeing that you understand there MUST be a meeting with the remote administrator. The remote administrator will contact you to set up the meeting. *
Check the box below agreeing that you understand students must maintain a 2.5 GPA. If the student falls below the 2.5 GPA, they may be required to return to in-person learning at the start of the second semester. *
Access to high-speed internet is a requirement for online learning. How does your family access the internet? If you do not have high-speed Internet currently, please contact 844-K12-OHIO to find out if you can qualify for other options.  Once you have high-speed Internet access, please resume filling out this form. *
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