W-A-Y Eau Claire Application
Thank you for applying to WAY Eau Claire!
Email address *
Today's Date *
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Email address: *
Your answer
Student's Full Name *
Your answer
Date of Birth *
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YYYY
Gender *
Required
Parent(s) or Guardian(s) Full Name *
Your answer
Street Address, City, State, Zip Code *
Your answer
Phone Number *
Your answer
PART II: School Information
Grade Level *
Required
What District are you currently enrolled? *
Required
If other, please list.
Your answer
List all the districts you have attended *
Required
Have you ever been expelled? *
Required
Have you ever been suspended? *
Required
Are you a student with an Individualized Education Plan (IEP)? *
Required
Are you a student with an 504 plan? *
Required
Do you have internet access at home? *
Required
How did you hear about W.A.Y. Eau Claire? *
Required
Why are you interested in WAY Eau Claire? *
Your answer
If more applications are received than program openings, a waiting list will be created and applicants will be assigned to the program when an opening becomes available. As parent(s) / guardian(s) making application for Schools of Choice under State Aid Act of 1996, P.A. 300, Section 105 and 105C for my / our child, my / our electronic signature on this application signifies my / our understanding and agreement to the Schools of Choice language and guidelines. My electronic signature also holds harmless Eau Claire Public Schools, its employees, and Board of Education members for any decisions made relative to the Schools of Choice language and guidelines. I certify that the information on this application form is accurate to the best of my knowledge. I acknowledge that inaccurate information may jeopardize the applicant's admission eligibility.I give my permission to our child's current (or most recent) school to release all school records for this student applicant. *
I give my permission to our child's current (or most recent) school to release all school records for this student applicant. * *
Required
Electronic Signature of Parent(s)/Guardian(s) *
Your answer
Electronic Signature of Student Applicant *
Your answer
A copy of your responses will be emailed to the address you provided.
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