Yukon Virtual High School Application

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Please complete this application and entry survey to request full-time virtual or blended programs for grades 9th-12th. Students who were unsuccessful in virtual school during school year 2020-2021 will be required to attend a meeting with their principal and/or counselor before the application is approved.

NCAA: If you need NCAA approved courses please contact your counselor. You can also contact the NCAA Eligibility Center, or admissions department at your college of choice for additional information regarding eligibility.

Program Requested: *

Full-Time Virtual (All courses online)

11th & 12th Blended Program (Courses online and on campus)

9th & 10th Blended Program (Specific program requirements apply. Please contact your counselor prior to completing an application. )

Independent 8th Hour Option

Student ID *

Student First Name *

Student Last Name *

School Year 21-22 Grade Level *

9th Grade

10th Grade

11th Grade

12th Grade

Date of Birth *

YYYY

Home Address *

Have you ever been identified to receive special services? (check all that apply.) *

IEP

504

English Learner

I do not receive any of the services above.

Required

Parent/Guardian Name *

Parent/Guardian Phone Number *

Parent/Guardian Email *

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