AWS - Blended (Limited Remote) Learning Application

Blended (Limited Remote) Learning Request
Eligibility Requirements
Requirements for Student: Has a medical need or other unique situation that makes attending classes on-campus impossible, is an independent learner, and is generally cooperative with the parent’s direction. Students must be current with their school work before applying for Blended Learning. For many students, this model of learning is not appropriate.
Requirements for Family: Attentive, available, and supportive parent; appropriate workspace for the student. For upper grades, this means keeping the students focused on their work and allowing for independent work.
Technology Requirements: Reliable internet connection. (AWS has a limited number of laptops which families may request to borrow if needed.)
Probationary period: The first 10 school days of Blended Learning are considered a probationary period.
Continuing Requirements: If the student cannot successfully participate in Blended Learning without falling behind, they will no longer be eligible to participate in Blended Learning.
Child's Name*

First NameLast Name
Grade*
Parent 1 Details
Parent 1 Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Format: (000) 000-0000.
Parent 2 Details
Parent 2 Name

First NameLast Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Blended (Limited Remote) Learning

I have read the 2020-21 AWS Instructional Scenarios and understand the limitations of the Blended (Limited Remote) Learning model and how it differs from Interconnected (Remote) Learning.
*

YesNo
Reason for requesting to participate in Blended Learning*

Medical: Please submit a note from your child's doctorOther
Which characteristics does the student/family display that makes them a good candidate for Blended Learning? Check all that apply*

The student is an independent learnerAn attentive and supportive parent or guardian is availableThe student is generally cooperative with parent’s requests and directions
How many hours is a parent or guardian available to support the student’s education each day?*

Less than 1 hour1 hour2 hours3 hours4 hours5 hours6 or more
Is the parent confident in their ability to deliver lessons based on material provided by AWS teachers?*

YesNo
What best describes the learning set-up in the home? Check all that apply*

There is an appropriate workspace for the student within the home.There is a reliable internet connection.The family/student has adequate access to a computer.The student needs to borrow a laptop from AWS.
Should be Empty:

Blended (Limited Remote) Learning Request

Parent 1 Details

Parent 2 Details