Special Program Agreement and Consent Forms

1

Parent Name* This field is required.Please type your first and last name below

First Name

Last Name

2

EmailPlease provide an email that you would like a receipt of your responses to go to.

example@example.com

3

Are any of your Middle School or High School Children interested in the NVLA Scholar Program?

YESNO

4

Was your family interested in the Scholar Junior Program?

YESNO

5

Does your child have an IEP or 504?

My child has an IEP

My Child has a 504

My child does not have either

What is an IEP or 504?

6

Is your child coming from a school outside the Clark County School District?

YESNO

7

File UploadWelcome to Clark County School District! Please upload the most recent copy of your child(s) IEP or 504 documents.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

8

Do you have a child that will be attending 8th or 10th grade with NVLA?

YESNO

9

Required Health Class FormFor each child that will be attending 8th grade at NVLA, please fill out the form at this link: https://form.jotform.com/223358033736153 For each child attending 10th grade at NVLA, please fill out the form at this link: https://form.jotform.com/223357298793168 Please list the name of the students if 8th and/or 10th grade below

10

Do you have a child attending NVLA for grades K-5?

YESNO

11

Will someone other than the immediate parent or guardian be acting as the Learning Coach?

YESNO

12

Learning Coach Permission FormPlease fill out the Learning Coach Permission form at this link: https://form.jotform.com/230186216350145 Then enter the name of the Learning Coach below.

13

Chromebook Checkout Loan Form

The below link will take you to a form for checking out a Chromebook from the school.

All NVLA students must use the school issued Chromebook so they can more easily separate school activities from personal activities. The GoGuardian application on the Chromebook also allows teachers to monitor school programs and better assist students when they are struggling with technology. The GoGuardian application is required for all NVLA students and is not to be disabled. This program is needed so that teachers can better support students.

https://form.jotform.com/211896016599165

14

This now concludes the Special Programs and Consent FormsPlease sign below to verify that all the information provided is updated to the best of your ability.

Powered by Jotform SignClear