New Student Registration Form

New Student Registration Form

Dreamers Virtual Learning Academy
Welcome future DVLA family!! Please complete one form per child. All registration forms are received and reviewed on a first come, first serve basis.

Email DreamersVirtualLearningAcademy@gmail.com with questions.
Student Information
Students First Name *
Students Last Name *
Does your child have a nickname that s/he prefers to be called? *

Yes No
If yes,what is it?
Gender *

Female Male
Birth Date *

Month Day Year
Home Phone *

Area Code Phone Number
Parent or Legal Guardian
Full Name *

First Name Last Name
Home *

Area Code Phone Number
Cell

Area Code Phone Number
Work

Area Code Phone Number
E-mail *
If you're unable to supervise your child during their class time, please name another trusted adult who might supervise your child during class time (First and Last name, relationship to child)
Developmental Milestones

Please help us determine which developmental milestones your child has already reached.
Cognitive Development *

Counts and understands the concept of counting Recognizes ABC's by sight Correctly names familiar colors Understands the idea of same and different, start comparing sizes Understands opposites Understand time better Works a 12 piece (or larger) puzzle Draws a two part (or 3 part) person Identify four colors when named Identifies shapes
Communication and Language Development

Follow 3 step directions without distraction Demonstrates understanding of difference between "is" and "is not" by pointing to objects Uses possessive forms of nouns Uses a series of conjunctions Averages at least five word sentences in conversations Describes items and/or objects in books Speech is clear and can be understood by others
Social Development *

Asks for help when needed Engages in cooperative play with smalls groups of children frequently Gives attention to stories for 10-15 minutes Says "please" and "thank you" without reminders Joins in mealtime conversations Initiates friendships with peers Plays interactive games Plays with peers with minimal conflict Interacts with adults in a cooperative, socially appropriate manner Asks permission to use items belonging
Comments
Expected Start Date? *

Month Day Year
Which grade level are you registering for? *
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New Student Registration Form

Student Information

Parent or Legal Guardian

Developmental Milestones