Application for Raleigh County Virtual Program
Raleigh County Virtual Consent Form- 2021-2022
I hereby consent to the West Virginia Virtual (Raleigh County) collection, use, and/or disclosure of information about my child through the course registration process and other manual and/or electronic procedures of the Virtual Program or associated course providers. I understand that my child is registering for a virtual course and that the information collected is needed for both course registration and grade/progress reporting to my child’s school. This consent form covers all forms of distance learning courses, included but not limited to satellite courses, video courses, and web-based courses. Your child’s image may be transmitted during video portions of distance learning and online courses.The information supplied to the course provider and/or the Virtual Program may include, but not be limited to student name, address, phone number, age, gender, school name, student grade in school, student email address, student progress and grade in the course/s.
A separate form must be completed for each child enrolling in the Raleigh County Virtual Program by Wednesday, July 28 at 5:00 PM.
You must complete a separate Opt-In form for each student . The Opt-In form must be submitted on or before July 28, 2021, by 5:00 PM. This is an application only and DOES NOT guarantee acceptance into the program. Classes will begin on August 30, 2021. Enrollment in the Raleigh County Virtual Program will be through the end of the second semester. Application for students who are receiving special services will be considered through the IEP process. All other student applications will be reviewed by the school eligibility team. Parents will be notified prior to August 10 regarding the acceptance of their application. Students must have completed the prior semester with a minimum 2.0 in all cores in order to be considered for virtual.
The Raleigh Virtual Platform will REQUIRE a minimum number of live sessions per week. Students will be receiving Progress Reports and 9 week report cards. For students to remain eligible, parents AND students will be required to attend an in-person regional orientation. Please email firstname.lastname@example.org for further information.
What is the intent for your child?
Yes, I want my child to attend Virtual School, and I understand that my child will remain in VS until the end of the second semester.
Is your child currently homeschooled?
Do you/Will you have reliable internet services in your home?
Yes, I want my child to attend Virtual School, and I understand that my child will remain in VS until the end of the second semester. (You can sign with your finger, mouse or a stylus)
I have read and understand Raleigh County Policy E. 18 Virtual School (You can sign with your finger, mouse or a stylus)
My student and I have reviewed and understand our responsibilities regarding Cyber Safety. (You can sign with your finger, mouse or a stylus)
Clear Fork Elementary
Coal City Elementary
Marsh Fork Elementary
Maxwell Hill Elementary
Shady Spring Elementary
Shady Spring High
Shady Spring Middle
Trap Hill Middle
Woodrow Wilson High
Child's Last Name
Child's First Name
Child's Middle Name
Parent/Guardian's Email. (Please use a working email for receipt of completed forms)
Parent/Guardian's Home Phone
Parent/Guardian's Work Phone
Parent/Guardian’s Email Address (if available, and if you want to receive progress reports that may be available from the course provider):
Raleigh County has taken this step in order to be in compliance with federal legislation for child protection, including The Family Educational Rights and Privacy Act (FERPA -http://www.ed.gov/offices/OM/ferpa.html) and the Children’s Online Privacy Protection Act (COPPA http://www.ftc.gov/os/1999/9910/64fr59888.htm). All students using computers from school locations must agree to abide by school, county, and/or West Virginia Board of Education Policy 2460 (Educational Purpose and Acceptable Use of Electronic Resources, Technologies and the Internet). It may be viewed online at http://wvde.state.wv.us/policies/, or you may request a copy from your child’s school. It is the intention of the West Virginia Department of Education to filter and restrict access to controversial materials from school computers. However, since the online courses are web-based, content accessed from home or elsewhere outside the school could put the student in contact with objectionable materials via the World Wide Web. It is the responsibility of the parent/guardian of the student to restrict any access to materials deemed inappropriate by the parent/guardian.
This agreement, agreements ancillary to this agreement, and related documents entered into in connection with this agreement are signed when a party’s signature is delivered by email or other electronic medium. These signatures must be treated in all respects as having the same force and effect as original signatures.
Signature- To sign, use your finger, mouse, or stylus in the box.
Please verify that you are human
Should be Empty: