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2019-2020 CHS Online Learning Enrollment Form
To enroll in an online class, please complete this form.
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* Indicates required question
Email
*
Your email
Student Information
Student First Name
*
Your answer
Preferred First Name
Your answer
Student Last Name
*
Your answer
Year of Graduation (4 digits)
*
Your answer
Student's School Email Address
*
Your answer
Do you have an IEP?
*
Yes
No
Do you have a 504 Plan?
*
Yes
No
Why are you taking an online class? *Be honest!
*
Your answer
Parent/Guardian Information
Please provide information for at least 1 parent or guardian.
Parent/Legal Guardian #1
*
Your answer
Relationship of Parent/Legal Guardian #1 to Student
*
Your answer
E-mail Address for Parent/Legal Guardian #1
*
Your answer
Parent/Legal Guardian #2 (Optional)
Your answer
Relationship of Parent/Legal Guardian #2 (Optional) to Student
Your answer
E-mail Address for Parent/Legal Guardian #2 (Optional)
Your answer
Please list any additional email addresses that you would like to receive E-mail updates
Your answer
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