Dear Parents/Guardians, 

Your help in our planning for the coming school year is appreciated as we need you to confirm your interest in having your student participate in our Distance Learning Academy. Please complete this form for each of your children.

If you choose for your child to be in our hybrid platform, please do NOT complete this survey.

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* 1. Student's Full Name:

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* 2. Student's DOB:

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* 3. Parent Information:

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* 4. School for 2020-2021 :

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* 5. Grade:

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* 6. Do you have reliable internet access in your household?

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* 7. Does student have a device to access the distance learning platform?

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* 8. I understand by completing this form, I am scheduling my student for the Distance Learning Academy.

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