Independent Study Student Information

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Please complete this form if you are interested in having your child participate in the PUSD Independent Study Program for the 2021-22 School Year.

This is not a Distance Learning Program but an Independent Study Program. Students will be required to participate on a daily basis and show academic progress or per State regulations, students will be required to return to their school site.

TK-3rd students will have daily instruction from a teacher 15-30 minutes each day.
4th-8th students will have contact from a teacher daily and instruction 15-30 minutes each week.

The remainder of the learning will be expected to be completed independently on a daily basis. Students are expected to have a total of 240 minutes of learning per day.

**Please complete this form for each child you have enrolled in the district.

Student Last Name *

Student First Name *

Parent Name *

Grade Level *

Contact Phone Number *

Address *

Does this child currently receive Special Education Services? *

Yes

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