2nd Semester: Eau Claire Virtual Academy Enrollment Form

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To provide families a choice, Eau Claire Public Schools has decided to continue offering our ECPS families the opportunity to enroll in the Eau Claire Virtual Academy for 2nd Semester. The ECPS Virtual Academy will support student learning through an established remote curriculum program. The target audience includes students who choose not to attend the traditional face to face school setting, either due to the medical fragility or family concern about exposure to COVID-19.

By completing this form you are committing to a semester-long enrollment. Please note that even though students are not physically attending the school building, DAILY attendance and completion of work is REQUIRED.

Please fill out a separate form for each student. The enrollment deadline is Wednesday, November 25, 2020.

Email *

Parent or Guardian Name *

Parent or Guardian Address *

Parent or Guardian Email *

Parent or Guardian Phone (please include area code) *

I understand I am committing my child to a semester-long enrollment in the ECPS Virtual Academy for 2020-2021. The semester is 1/04/2021 - 06/08/2021. *

Yes

I understand that my child will not be able to participate in athletics while enrolled in ECPS Virtual Academy. *

Yes

Student's Full Name *

Student's D.O.B. *

Student's Grade Level for 2020-2021 *

Does the student require any special services or currently have an Individualized Education Plan (IEP) or receive Title Services? *If so, please note that choosing this option may not be in the best interest of your child as accommodations may or may not be available in the Virtual setting. *

No my child does not require any special services, have an IEP or 504 plan, or receive Title Services

Yes my child requires services (Describe below)

Describe the special services your child needs.

Is there a second household with shared educational rights? This answer will be verified by information in PowerSchool. * *

Yes, If yes, please answer following questions regarding a second household.

The decision to enroll this student in the Eau Claire Virtual Academy is in agreement by both households. *

Yes

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