Middle School 2019-20 RCPS Specialty and Choice Application

2020-21 RCPS Middle and High School Virtual Option Interest Survey
Please complete one interest survey per child and complete all information as requested. Completion of this survey does not guarantee admission. All those who indicate a desire for full-time virtual learning will be sent further information and instructions on how to apply for the middle or high school virtual learning option.

This survey must be completed at one time. Once submitted, you may not return back to add or modify information.

Student Information
Student Name *

First Name Middle Name Last Name
Student Number
Student Birth Date *

Month Day Year
Which school are you enrolled in for the 2020-21 school year? *
Grade Level *

Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12
Parent Information
Name of Parent/Legal Guardian *

First Name Last Name
Primary Phone Number *
Parent's Email Address *

Confirmation Email

Middle and High School Virtual Program Option
Please indicate your level of interest in a full-time virtual learning option for the 2020-21 school year. *

Extremely interested - this is our preferred learning option Somewhat interested - not sure yet Not interested
School Nutrition

RCPS School Nutrition is developing a plan to provide meals to students choosing the virtual program option. These meals may require your normal school lunch charges and may require pick up from a meal bus route during the day.
Do you have an interest in receiving school meals while attending virtual school? *

Yes No
Signature of Parent or Guardian: *
Date: *

Month Day Year
Availability of 6-12 Virtual Learning is subject to RCPS program offerings.

The Rockdale County Board of Education (“Board”) prohibits unlawful discrimination against students because of race, color, national origin, sex, religion, age, disability, or other protected group status or activity (e.g. opposition to prohibited discrimination or participation in the statutory complaint process) in its programs and activities or employment in its programs or activities. In keeping with this commitment, the Board will not tolerate harassment, discrimination, or other unlawful treatment of its students. It is the policy of the Board to comply fully with the requirements of Title VI, Title IX, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act and all accompanying regulations. As set forth herein, the Board designates the following employee of Rockdale County Public Schools (“District”) to handle inquiries regarding the District's non-discrimination policies:

Director of Community and Student Support (or designee) Rockdale County Public Schools
954 North Main Street Conyers, Georgia 30012
T: (770) 483-4713
www.rockdaleschools.org
Should be Empty:

2020-21 RCPS Middle and High School Virtual Option Interest Survey

Student Information

Parent Information

Middle and High School Virtual Program Option

School Nutrition