Virtual Vermilion  2020-21 Student Registration
Read the following information carefully and submit a separate form for each child being registered for our Virtual Vermilion Program.

******All students who register for Virtual Vermilion on or after August 26th must have access to a computer, tablet, or laptop and internet access.  Students cannot complete any course work if they do not have a device and/or internet access. ******
*****  All students who register for Virtual Vermilion for the Spring semester are committed to, and must remain with the Virtual Vermilion program through the end of the 2020/2021 school year (5/28/21).  Virtual Vermilion students cannot return to their face-to-face school at any time during the remainder of the 2020-2021 school year.**********
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Student's First Name: *
Student's Middle Name:
Student's Last Name: *
2020-2021 School: *
Grade: *
Student ID #:
Birth date: *
MM
/
DD
/
YYYY
Home Address: *
City: *
Zip: *
Mailing Address: (if different from above)
Mailing City
Mailing Zip:
Student Home phone #:
Student Cell phone #:
Parent/Guardian Name: *
Parent/Guardian - Home phone #: *
If Home/Cell is the same, please list the same in both.
Parent/Guardian - Cell phone #: *
If Home/Cell is the same, please list the same in both.
Parent/Guardian - Work #:
Alternate Contact Name: *
Two forms of contact are REQUIRED for virtual learning.
Alternate Contact #: *
Two forms of contact are REQUIRED for virtual learning.
Primary Parent Email: *
**Please ensure that this is an accurate email address that is checked regularly.  Email is our primary form of communication with parents**
Secondary Parent Email (Optional):
**Email is our primary form of communication with parents**
Please indicate services provided to your child in the traditional classroom:  
Did your child attend a Vermilion Parish public school last year (2019/2020)?
Clear selection
If your child did NOT attend a Vermilion Parish public school, which school did your child attend last year (2019/2020)?
Please answer the following:
Yes
No
My child has access to a smartphone with internet access for periodic (approximately once per month) test proctoring.
For Kindergarten - 6th grade students: My child will have an adult present during all online coursework.
Clear selection
Why do you feel the Virtual Vermilion Program may be a better learning environment for your child:
Please type in the box below the following statement:  "My child has access to a device and the internet." *
All students who register for Virtual Vermilion on or after August 26th must have access to a computer, tablet, or laptop and internet access.  Students cannot complete any course work if they do not have a device and/or internet access. We have designated all prior requests for Chromebooks, and due to unusually high demand across the country, we will not have any additional Chromebooks for at least 2 months.  
Please type in the box below the following statement:  "My child will remain with the Virtual Vermilion program through May 28, 2021." *
  All students who register for Virtual Vermilion for the Spring semester are committed to and must remain with the Virtual Vermilion program through the end of the 2020/2021 school year.  Students cannot return to their face-to-face school at any time during the remainder of the 2020-2021 school year.
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