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Estill County School District Virtual Academy- Grades K-5 Application 2024-2025. Please complete this form for all applicants incoming Kindergarten - 5th graders. Please complete one form per child.
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* Indicates required question
Student Name
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Your answer
Parent/Guardian Name(s)
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Your answer
Parent/Guardian Email Address
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Your answer
Parent/Guardian Phone Number
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Your answer
Student Residential Street Address:
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Your answer
City of Residence, State and Postal Code:
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Your answer
Student Current Graded Level:
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Your answer
Student's Date of Birth:
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MM
/
DD
/
YYYY
Is the student currently enrolled in the Estill County School District?
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Yes
No
What school is the student currently enrolled in? If enrolled outside of Estill County please also describe location (District, City, State, Country).
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Your answer
Does your student receive IEP (Individual Education Program), a 504 Plan or Special Education Services? You can share any needs that you think are important prior to an intake meeting.
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Your answer
Do you have daily, dedicated high speed, reliable internet? This includes, DSL, Cable, Satellite, or non-cell phone hotspot access.
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Yes
No
Who is your internet service provider and what is your capable download speed? (Check your speed at
www.speedtest.net
)
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Your answer
If you know your student's attendance record from the previous year please describe here. (Example: 2023-2024 School year student missed 6 days of class for physical therapy appointments.
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Your answer
Describe student behavior concerns you feel important for our staff to know about in this section.
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Your answer
In a short paragraph, explain why your student is best suited for the Virtual Academy.
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Your answer
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