Northampton County Schools' Student Learning Option Form for Remainder of the 2020-21 School Year
DUE: Monday, February 8, 2021 at 12:00 p.m. (After Feb 8 at 12:00pm, district staff will be working to complete the surveys for those parents who did not complete prior to).
Parents/Guardians: Please complete this form for each child enrolled in Northampton County Schools. The choice you make for your student will be in place through May 21, 2021 for Grades 9-12 (Early Calendar) or June 3, 2021 for Grades PK-8 (Traditional Calendar). All state testing will be required in both remote and face to face learning choices.
If you select remote learning, your scholar will participate in virtual learning opportunities for Northampton County Schools' scholars. Please complete this survey for each child by Monday, February 8, 2021 at 12:00 p.m.
Scholars will be provided instruction for courses needed for grade level promotion as well as high school graduation. There will be opportunities for 1:1, small group, and self-paced remote instruction as well as support for our special population scholars. Students registered for the remote learning option are expected to remain in that particular environment until courses are complete through the end of the 2020-2021 school year.
* Required
Email address
*
Your email
Do you have a thermometer at home to check your child's temperature daily before leaving for school?
*
Yes (or I can get one)
No
Please identify your role in completing the survey
*
Parent/Guardian
School Staff Member
ONLY answer this question if you are a school staff member completing the survey on behalf of a parent. Please state your first and last name below.
Your answer
Are there any address or phone number changes that you need for us to correct in PowerSchool that you will be listing?
*
Choose
Yes
No
Scholar's First Name (Please complete a separate form for each of your children):
*
Your answer
Scholar's Last Name:
*
Your answer
Student's Date of Birth:
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MM
/
DD
/
YYYY
Gender:
*
Male
Female
Prefer not to disclose
School your child is attending currently:
*
Choose
Central Elementary
Conway Middle
Gaston Elementary
Gaston Middle
Northampton County Early College
Northampton County High
Willis Hare Elementary
Current Grade Level:
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Choose
Pre-Kindergarten
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Grade 13
Student's PowerSchool Number (if known):
Your answer
Student's Email address (if known):
Your answer
Student's Home Street Address (no PO Box numbers):
*
Your answer
City:
*
Your answer
State:
*
Choose
NC
VA
Zip Code:
*
Your answer
Parent/Guardian First Name:
*
Your answer
Parent/Guardian Last Name:
*
Your answer
Parent/Guardian Email Address:
Your answer
Parent/Guardian Daytime Phone Number
*
Your answer
I intend for my scholar to participate in the following learning option:
*
Option 1: Return to school face-to-face 5 days a week
Option 2: Return to school face-to-face on an A/B schedule (blended learning option. Students must engage in learning 5 days a week))
Option 3: Remain with Instruction via Remote Learning option (Students must engage in learning 5 days a week whether face-to-face or virtual)
I request the following transportation method for my scholar:
*
Bus Rider (If they will ride the bus at any point, please select Bus Rider)
Car Rider
Walker
Send me a copy of my responses.
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