HDPA K-6 Grades Offline Minutes Verification
ONE form PER DAY with ALL SUBJECTS

Form must be submitted WITHIN THE SCHOOL WEEK work is completed (Monday-Sunday)! Offline forms submitted after Sunday at midnight will be discarded.

Complete one form for EACH DAY and record all OFFLINE ONLY minutes for that day.

This form may ONLY be submitted WITH PARENT OR GUARDIAN approval and verification. By typing a parent or guardian name in the signature box, you are acknowledging the parent or guardian is verifying the offline time being submitting. Any submission completed without parent or guardian knowledge will be considered a forgery and be dealt with as such.

Please provide a Parent/Guardian email address. ONLY if parent/guardian does not have an email address, use student email address.
Email address *
Student Last Name *
Student First Name *
Student ID # *
Name of Teacher *
Date Offline Minutes Were Completed *
MM
/
DD
/
YYYY
TOTAL Number of Offline Minutes Completed on This Date in All Subjects *
Enter minutes to the whole digit - round to the nearest minute.
Area(s) of Study: *
Select all that apply to the date/time you are entering
Required
Describe ALL Offline Activities Completed on This Date. *
Parent/Guardian Verification
By typing a parent or guardian name in the signature box, you are acknowledging your parent or guardian is verifying the offline time you are submitting. Any submission completed without parent or guardian knowledge will be considered a forgery and be dealt with as such.
Parent/Guardian Signature *
Include first and last name of parent/guardian
Parent/Guardian Phone Number (with area code) *
Please use the following format: ###-###-###. We will randoming call to verify the data submitted with this signature and phone number.
A copy of your responses will be emailed to the address you provided.
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