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ESVCA Enrollment Application

Oklahoma Enrollment Application

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 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's 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)

Federal Programs

Eschool Virtual Charter Academy does not participate in the federal school lunch program. However, the school does qualify for federal funding for certain programs based on students' eligibility for the school lunch program. These funds are used primarily for hiring of intervention staff and programs to assist students in their academic growth.
Which of the following best describes the total combined income reported above?

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 1 Name(Required)
MM slash DD slash YYYY
Is Student 1 Hispanic or Latino(Required)
Race: How does Student 1 Identify?(Required)
Student 2 Name
MM slash DD slash YYYY
Is Student 2 Hispanic or Latino
Race: How does Student 2 Identify?
Student 3 Name
MM slash DD slash YYYY
Is Student 3 Hispanic or Latino
Race: How does Student 3 Identify?
Student 4 Name
MM slash DD slash YYYY
Is Student 4 Hispanic or Latino
Race: How does Student 4 Identify?
Student 5 Name
MM slash DD slash YYYY
Is Student 5 Hispanic or Latino
Race: How does Student 5 Identify?
Is the student currently in foster care? (If so, please send foster care documentation to records@eschoolacademy.org)(Required)
Is the student currently home schooled?(Required)
Are any of the above listed students being served on an Individualized Education Program (IEP)?(Required)
If you answer yes to the above question, please list the name(s) of student(s) that are being served on an Individualized Education Plan.

Previous School District

The following information will help our Registrar more accurately obtain proper student records for processing, enrollment, and scheduling of classes.

Consent

Consent(Required)
Media(Required)
Field Trip(Required)

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

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