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DVIA Request For Course - ForM

The document is a request form for a student to take an additional virtual course through Duval Virtual Instruction Academy while enrolled in their current school. If approved, the student understands the course must be completed by the end of the semester/school year to receive credit. The student also understands they can be withdrawn for lack of weekly participation, resulting in a grade of F. Both student and parent signatures are required to show approval of these policies. The guidance counselor and school principal must also approve the request before it can be processed to add the virtual school as a second school of enrollment.

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Mrs. Libby
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© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
652 views

DVIA Request For Course - ForM

The document is a request form for a student to take an additional virtual course through Duval Virtual Instruction Academy while enrolled in their current school. If approved, the student understands the course must be completed by the end of the semester/school year to receive credit. The student also understands they can be withdrawn for lack of weekly participation, resulting in a grade of F. Both student and parent signatures are required to show approval of these policies. The guidance counselor and school principal must also approve the request before it can be processed to add the virtual school as a second school of enrollment.

Uploaded by

Mrs. Libby
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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REQUEST FOR AFTER SCHOOL VIRTUAL COURSE(S)

STUDENT INFORMATION: (Please print all information) _________________________ ______________________ _____ _________________ __________ LAST NAME FIRST NAME MI STUDENT ID# GRADE ______________________________________________ NAME OF CURRENT SCHOOL OF ENROLLMENT
I would like to take a virtual course offered through Duval Virtual Instruction Academy in addition to my current class load. If approved, I understand that the course(s) must be completed by the end of the current semester/school year (as appropriate) in order to be awarded credit. I also understand I will be withdrawn from the course if I do not participate by submitting work on a weekly basis. Withdrawal from the course prior to completion will result in a grade of F.

__________________________________ STUDENT SIGNATURE PARENT/GUARDIAN APPROVAL:

_______________________________ DATE

I would like for my child to take a virtual course offered through Duval Virtual Instruction Academy in addition to his/her current class load. If approved, I understand that the course(s) must be completed by the end of the current semester/school year (as appropriate) in order to be awarded credit. I also understand I will be withdrawn from the course if I do not participate by submitting work on a weekly basis. Withdrawal from the course prior to completion will result in a grade of F.

_________________________________ PARENT/GUARDIAN SIGNATURE

_________________________________ DATE

TO BE COMPLETED BY SCHOOL GUIDANCE COUNSELOR: COUNSELOR INFORMATION: _______________________ _______________________ Print Name SIGNATURE Provide the course title and ID# then select Yes or No to indicated counselor approval and initial. COURSE TITLE COURSE ID # COUNSELOR INITIALS ____________________________ _________________________ ____________________________ _________________________ YES / NO ________________ YES/NO ________________

ADMINISTRATIVE APPROVAL: Submit to school Principal or designee for approval and entering school 7006 as 2nd School of Enrollment for the student. Once complete, fax to DAWN ELKINS 904-390-2075. _________________________________ PRINCIPAL/DESIGNEE SIGNATURE *Incomplete requests will not be processed _________ DATE
CRT/DATA ENTRY ENTER 7006 AS 2ND SCHOOL OF ENROLLMENT AND INITIAL AFTER COMPLETE. _________________ CRT INITIALS _________________ DATE

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