Online Application

Online Application

Virtual Program Application:

*

Student Name.
*

Parent or Guardian Name.
*

Student Date of Birth.
*

Home Phone Number.

Cell Phone Number.
*

Student's Address.

Parent's address (if different than student).

School History:
*

Last school attended.
*

Check current grade.
4K
  K
  1
  2
  3
  4
  5
  6
  7
  8
9
  10
  11
  12
*

Are you currently receiving or have you ever received special education services?  (ED, LD, CD, Section 504)

 (1 required)
Yes
  No

 If "yes", please give an explanation of the nature of the special education services provided in the space below:
*

What type of virtual program are you interested in?

 (1 required)
K-6 Virtual with access to electives on site at Marshfield Elementary (to be designated).
7-8 Virtual with access to electives on site at Marshfield Middle School
9-12 Virtual with access to electives on site at Marshfield High School
Virtual enrollment for all graduation requirements.

Complete the following questions by selecting one of the 3 following options:

(1) - Most of the time         (2) - Sometimes          (3) - Rarely
*

I am self motivated.
1
  2
  3
*

I can manage my time well.
1
  2
  3
*

I am capable of self-discipline.
1
  2
  3
*

I am able to comprehend what I read.
1
  2
  3
*

I am goal oriented. If I set my sights on an end result, I achieve it.
1
  2
  3
*

I am confident in my academic abilities.
1
  2
  3
*

I do not give up easily, even when confronted with obstacles.
1
  2
  3
*

I believe I am responsible for my own education. What I learn is ultimately my responsibility.
1
  2
  3
*

I have commuting problems.
1
  2
  3
*

I have conflicts with work, athletics or child care and school schedules.
1
  2
  3
*

I have access to a computer with an internet connection.
1
  2
  3
*

I am willing to try something new.
1
  2
  3
*

I am willing to work in a non-structured environment.
1
  2
  3
*

I am willing to express my opinion in writing.
1
  2
  3
*

I am willing to actively participate in the learning process by doing tasks, projects, etc.
1
  2
  3

Answer the following questions by selecting either Yes or No.
*

Does your computer have a fast and reliable internet connection?
Yes
  No
*

Are you comfortable using the internet?
Yes
  No
*

Do you know how to write and send e-mails?
Yes
  No
*

Do you understand material best when it is presended visually? Examples - Pictures, written words, charts, graphs etc.
Yes
  No
*

Do you have enough time each day to commit to studying?
Yes
  No
*

Will your family and friends be supportive of your need for time to study?
Yes
  No

Type in the text that you see above:

  

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