Blended Learning Schedule Parent Permission 
Students with a Blended Learning Schedule in block 1 or 4  have the option of  flexible attendance.   A blended learning schedule class includes: Open Campus, Edgenuity, Work Study, Independent Study, Dual Enrollment, Career Internship, and Service Learning. These classes would be combined with typical "Brick and Mortar" classes.

Students with a Blended Learning Schedule during block 1 have the option of arriving to school prior to the start of block 2 with parent permission on the form listed below.  Students with an Blended Learning Schedule during block 4 have the option of leaving school at the conclusion of block 3 with parent permission on the form listed below.  Students with a Blended Learning Schedule Block during block 2 or 3 must remain in the building. Students should review the specific expectations and procedures for Blended Learning Schedules. 

Students must be in good standing and have reliable transportation to be permitted to have flexible attendance. Students with flexible attendance must sign in/out in the attendance office.  

Sign in to Google to save your progress. Learn more
Email *
Student Last Name 
Student First Name
Student ID
Student Grade
Clear selection
This Google Form is valid for 
Clear selection
My student's blended learning schedule is for ...
My student's  blended learning schedule is in ...
Name of parent/guardian completing the form.  By typing your name you acknowledge that you have reviewed the procedures and expectations for Blended Learning Schedules and that you give permission for flexible attendance if your student meets the requirements. 
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Penn Manor School District. Report Abuse