Remote Learning Registration Form
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電子郵件 *
About your child:
Fill out this form if you authorize registering your child in Liberty Elementary School's school within a school for Remote Learning in the Liberty Elementary School District. Please fill out one form per child . * The Remote Learning Option is FULL and your child will be placed on a WAITLIST.
Child Legal First Name (per birth certificate or court documents) *
Child Middle Name/Initial *
Child Legal Last Name (per birth certificate or court documents) *
Liberty Student ID Number  (student lunch number or ParentVue account number) *
Date of Birth *
MM
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DD
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YYYY
Gender *
Grade Level (for the 2021-2022 School Year) *
Which Liberty Elementary School is your child enrolled for the 2021-2022 school year? *
Parent Contact Information ( Name and Phone) *
By signing your signature below you acknowledge the following:  You are the parent (per birth certificate) or legal guardian (per court order) and have educational rights to make this choice on behalf of your child.  Your child will be withdrawn from his/hercurrent school. Your child will be enrolled in the Liberty Elementary School and assigned a remote learning teacher for the 2021-2022 school year in the Liberty Elementary School District #25. Some scheduled in-person assessments will be required. This application is for the entire school year.  Additional communication may be required to confirm admission.
系統會透過電子郵件將你的作答內容複本傳送到你所提供的地址。
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清除表單
請勿利用 Google 表單送出密碼。
這份表單是在 Liberty Elementary School District 中建立。 檢舉濫用情形