RCS Virtual Learning Academy Application FY22
Please complete the following application.  Upon completion you will be sent the final documents and details for your signature.  Registration will be for the entire 2021-2022 school year.  This application will remain open as long as there is available space.
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Student Legal First Name *
Student Legal Middle Name
Student Legal Last Name *
Parent/Guardian Full Name completing this application *
Parent/Guardian Address *
Parent/Guardian Phone Number *
Parent/Guardian Email Address
Current School (If not in Rome City, please list school and school district) *
Current Grade Level *
Do you have reliable Internet access at home that will work for video calls and class work? *
Did your child participate in VLA this year? *
Does your child currently receive special education services (have an IEP)? *
Does your child currently receive services as a student with English as a Second Language (ESOL)? *
Does your child currently receive gifted student services? *
Does your child currently have a 504 plan? *
Please type your name as your signature for this statement:  I understand that I am applying for my child to attend the virtual learning academy for the entire 2021-2022 school year with no option to return to in-person learning until the 2022-2023 school year.  Acceptance will be based on available space and courses(9-12).   *
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