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Wapato Online Academy: 2026-27 School Year STUDENT INTEREST SURVEY
(Must be filled out as part of the enrollment process for WOA)
1.
Student Contact Information
Student Name
Address
City/Town
ZIP/Postal Code
Email Address
Phone Number
2.
Parent Contact Information
Parent Name
Address
City/Town
ZIP/Postal Code
Email Address
Phone Number
3.
What is your current school?
Simcoe
Camas
Adams
Satus
WMS
PACE
WHS
Other (please specify)
4.
Student Birthdate:
Please enter your birthdate MM/DD/YYYY
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
5.
Student's Current Grade:
K
1
2
3
4
5
6
7
8
9
10
11
12
6.
Areas of Concern (parent or school)
Attendane
Discipline
Academic Performance
Other (please specify)
None of the above
7.
Current Special Accommodations:
Special Education
504
Health Impairment
Migrant
Homeless
Other (please specify)
None of the above
8.
Please tell us why you are interested in enrolling in the Wapato Public Schools Online Academy.
9.
How did you hear about the Wapato Public Schools Online Academy?
District website
Counselor
Friend
Other school personnel
Other (please specify)
10.
For which semester are you enrolling in the Wapato Public Schools Online Academy?
2025-26 Semester 1
2025-26 Semester 2
11.
Completing this survey does not guarantee placement in the online program.
I have read the above statement.