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Enrolling 1 Student

ESVCA Enrollment Application (1)

Parent/Legal Guardian Section

This section should be completed by the parent/legal guardian acting as the primary point of contact for Eschool Virtual Charter Academy.
Parent/Legal Guardian Name(Required)
Please list the name of the parent/guardian who is the primary point of contact for the student being enrolled.
MM slash DD slash YYYY
Preferred Form of Contact(Required)
Parent/Legal Guardian Household Address(Required)
The student’s family must have a legal residence in the state of Oklahoma in order to attend public school. Please list the legal Oklahoma residence at which the student resides.
Is the parent/legal guardian a member of the active uniformed military services of the United States and on full time active-duty status or active-duty orders?(Required)
Has this person, within the past 36 months, relocated with the intent to obtain seasonal or temporary employment in agriculture, fishing, and dairy of food processing work?(Required)

Emergency Contact

Please list the name and phone number of someone, other than you, that can be reached in the event of an emergency.
Emergency Contact Name(Required)

Student Section

Student Name(Required)
Gender (As shown on birth certificate)(Required)
MM slash DD slash YYYY
Is Student Hispanic or Latino(Required)
Race: How does Student Identify?(Required)
Is the above listed student being served on an Individualized Education Program (IEP)?(Required)

Consent

Media(Required)
Field Trip(Required)
Text Messages(Required)
This field is for validation purposes and should be left unchanged.

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Name*
This field is for validation purposes and should be left unchanged.

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