SPS Online Learning Support Registration
Please answer the following questions for registration
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Email *
Child's Name:
Child's Date of Birth
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DD
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Child's Gender
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Child's Grade
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2020-21 Elementary School and Teacher's Name *
Please enter the product number
Select the days your child will be doing online learning with us. *
Please enter the product number
Parent/Guardian 1: Name and Last Name *
Please enter the product number
Parent/Guardian 1: Address
Parent/Guardian 1: Preferred Phone Number
Choose size and number per color
Parent/Guardian 1: E-mail
Parent/Guardian 2: Name and Last name *
Parent/Guardian 2: Address
Parent/Guardian 2: Preferred Phone number *
Parent/Guardian 2: E-mail *
Please list any other adults or children living with the student, starting with the oldest. Please include name, date of birth, and present school or employer *
What activities does the student pursue? *
Does your child have an IEP or 504 plan? *
Please enter the product number
Is this child adopted? *
Has the student repeated or accelerated any grades? *
Has the student ever been suspended or expelled? *
How can we help encourage this student? *
Special behavior, learning, medical, emotional or physical supports the student needs to be successful? *
Concerns regarding student's current progress (academic, social, behavioral, physical)? *
Does this student have any medical conditions or allergies that may impact their experience? *
List any allergies or health conditions we should be aware. *
Please enter the product number
Do you want to tell us anything else about your child? *
Please enter the product number
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