2021-2022 Virtual Learning Registration Form
Complete this form to register your child for Peninsula District Virtual Learning option for the 2021-2022 school year.  If you have more than one student, please complete a form for each child. Once registered, our staff will reach out to you to coordinate orientation and enrollment information. We look forward to serving our students and families!
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Student Last Name
Student First Name
Grade level for the 21-22 school year
Neighborhood School
Parent/Guardian Name
Parent/Guardian Phone
Parent/Guardian Email
Student Services
Please select if your student receives any of these following services. Feel free to add notes in the Other Field.
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