Broadview Change of Learning Model Request Form

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IMPORTANT INFORMATION, PLEASE READ:
Complete this form to request a change in Learning models. There are two Learning models. The Hybrid model in which students are in school on Monday/Tuesday or Thursday/Friday. The other is Full Distance learning which is the model we are in currently.

IMPORTANT: THIS FORM IS NOT FOR COHORT CHANGES, please call the office at 203-797-4861 or 203-797-4862 for Cohort Changes. Cohort changes are not guaranteed but have to be evaluated on an individual basis. All requests for change must be made by Thursday, 1/14/21 for your child to start in-person school on 1/25/21.

Email *

Email Address *

Student last name *

Student first name *

Student ID *

Grade *

Grade 6

Grade 7

Grade 8

I would like to change to *

Distance Learning

Hybrid Model

Required

I need bus transportation because I am moving to a hybrid program

Yes

Send me a copy of my responses.

Submit

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