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Student Information Update Form
Important: For students currently enrolled at CVA only! Please press the SUBMIT button at the end to ensure that CVA receives this information.
Please note that this form does NOT enroll students into CVA.
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* Indicates required question
Email
*
Your email
This form is only used to convey general updates/ clarifications/ corrections. If you need to convey any health/emergency or medication related changes for your student, please call the front office to ask for and fill out specific forms.
Contact: Esther Delacruz at (651)-523-7170 or email her at
edelacruz@cybervillageacademy.org
Student's First and Last Name
*
Your answer
CVA Program
*
Please select one: Fusion (3 days on-campus, 2 days online - grades K-12) or PASCAL (fully online - for grades 6-12 only).
Fusion
PASCAL
Grade Level
*
The student's grade level at CVA in 2020-21
Choose
KG
1
2
3
4
5
6
7
8
9
10
11
12
Parent's/Guardian's First and Last Name
*
Your answer
Please update information for
New primary address
New secondary address
New phone no(s).
Change in parent/ guardian email
Other:
Date of Change of Address
MM
/
DD
/
YYYY
Old Primary Address (student's old address)
Your answer
New Primary Address (student's new/current address)
Your answer
Primary Address belongs to:
Mother/Parent 1
Father/Parent 2
Guardian
Other:
Clear selection
Is this also the mailing address?
Yes
No
Clear selection
Secondary Contact Address
Your answer
Secondary Address belongs to:
Mother/Parent 1
Father/Parent 2
Guardian
Other:
Clear selection
New Phone No.1
Your answer
New Phone no.2
Your answer
New Emails (separate addresses by comma)
Your answer
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