Clinton HS All-Virtual Option - Enrollment Request
By submitting this form, I am transferring my student from the traditional school environment to Clinton Public Schools Virtual Option.  In doing so, I confirm that:
1.  I understand there must be an adult learning coach (parent, guardian, grandparent, etc.) available to help the virtual student 6-8 hours per week.
2.  I understand enrolling in the Virtual Academy is a semester-long commitment and the student cannot transfer back to the traditional school environment until January 2021.
 
Your school counselor will contact you prior to September 25th.
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Full name of the student requesting enrollment. *
Student ID (Lunch Number) of student.
Student's grade for the 20/21 school year *
Student's current address *
Parent/guardian(s) name *
Parent/Guardian(s) phone number *
Student is on an IEP/504 *
Student will participate in an extracurricular activity. Check all that apply. (note: participating in an extracurricular activity will require in-person attendance for those activities.) *
Required
Student plans to play collegiate sports and needs NCAA approved courses *
I understand the following conditions - check each that you understand. *
Required
Name of the adult learning coach (parent, guardian, grandparent, etc. ) who will be available to help the student: *
What is the relationship between the learning coach and the student? *
Required
Email of the adult learning coach who will be available to help student *
Phone number the of adult learning coach who will be available to help the student *
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