Octorara Virtual Academy Application
Student First Name *
Your answer
Student Last Name *
Your answer
Is this your first time taking an online class? *
Will you be submitting these online courses to the NCAA Clearinghouse? *
Required
Student Email Address *
Teachers and Staff will need to use this address to communicate with you.
Your answer
Phone Number (Format - 6101234567) *
Your answer
Current School *
Grade (2018-19 school year) *
Your answer
Current School Counselor *
Do you have an IEP?
Parent First Name *
Your answer
Parent Last Name *
Your answer
Parent Email Address *
Your answer
Parent Phone Number (Format - 6101234567) *
Your answer
Requested Courses *
Please list the courses you would like to take. If you are unsure and would like assistance from a counselor, please indicate that in your answer.
Your answer
Requested Start Date *
Please note the date you wish to start. This may be subject to change due to review of this application.
MM
/
DD
/
YYYY
Reason for requesting courses through OVA *
Your answer
Any Additional Information *
If you believe there is any additional information you think we need to know, please list it below.
Your answer
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