Enrollment

This form is to be completed if you would like to sign your student(s) up for our Online Learning Option during the 2020-2021 School year due to the COVID-19 pandemic.

Parent/Guardian Information

This sign-up form does not take the place of our Student Registration Paperwork. This will still need to be completed for your student(s) to start this fall. Please complete that form and turn it into the building's front office if you have not already done so.

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email Address

Parent/Guardian Phone Number

Student (1) Information

Student (1) First Name

Student (1) Last Name

Student (1) Building

Student (1) Grade

Does Student (1) use special education or speech services from our staff? (required) Yes No

Student (2) Information

Student (2) First Name

Student (2) Last Name

Student (2) Building

Does Student (2) use special education or speech services from our staff? Yes No

Student (2) Grade

Student (3) Information

Student (3) First Name

Student (3) Last Name

Student (3) Building

Student (3) Grade

Does Student (3) use special education or speech services from our staff? Yes No

Student (4) Information

Student (4) First Name

Student (4) Last Name

Student (4) Building

Student (4) Grade

Does Student (4) use special education or speech services from our staff? Yes No

With this learning option, your student will have access to a school-provided Chromebook. Do you intend for your student to use this device? (required) Yes No

Do you need assistance in providing internet service at your home for your student to complete their Online Learning coursework? (required) Yes No

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Soaring with Opportunities!

Enrollment

Welcome to Kelloggsville Public Schools!

2020-2021 Online Learning Sign Up