2024-25 Student Enrollment Packet
Welcome to Inspire Virtual Academy. We are pleased that you are here. In order to prevent a delay in registration, please complete the form entirely. If you experience any difficulty, feel free to visit us on-campus and we will assist you in person.
Date
*
-
Month
-
Day
Year
Date
Student's Name
*
First Name
Middle Name
Last Name
Sex
*
Male
Female
Does the student play sports or participate in the band at their zoned school?
Yes
No
No, but would like to
School the student is transferring from
I understand that I need to do the following at my zoned school before my transfer can be processed:
Turn in any technology assigned to the student by the zoned school
Turn in any textbooks assigned to the student by the zoned school
Clear up any financial holds placed on the student's account by the zoned school
Complete any discipline assigned by the zoned school
Inform your coach(es), club coordinators, and/or band director of your change
School Name
*
School's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Current Grade Level
*
Student's Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student's Mailing Address (If different from physical address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
*
Please enter a valid phone number.
Parent/Guardians
Student lives with
*
Please Select
Parents
Mother
Father
Grandparent(s)
Other Guardian
Mother/Guardian
*
First Name
Last Name
Email
*
example@example.com
Guardian's Primary Phone Number
*
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Father/Guardian
First Name
Last Name
Email
example@example.com
Primary Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Special information about custody
Emergency Contacts
Emergency Contact 1
Contact
*
First Name
Last Name
Relation
*
Phone Number
*
Please enter a valid phone number.
Emergency Contact 2
Contact
*
First Name
Last Name
Relation
*
Phone Number
*
Please enter a valid phone number.
Parent/Guardian's Signature
*
Ethnicity and Race
Please answer both questions 1 and 2
Is the student Hispanic/Latino?
*
No, not Hispanic or Latino
Yes, Hispanic/Latino (a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.)
What is the student's race? Choose on or more:
*
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Have you updated all student information in PowerSchool?
Yes
Not yet
Additional Requested Information
Student is connected to an active duty military family
*
Yes
No
Preschool (select all that apply)
*
No preschool
Head start
Center-based Child Care
Home visitation program
First class funded preschool
Home-based child care
Other preschool
Special education funded
Why are you transferring?
*
Do you have any outstanding discipline problems from the previous school?
*
Yes
No
If yes, please explain
Did you receive and special education services at your previous school? (IEP, EL, 504, Etc).
*
Yes
No
Are there any health issues we need to know about?
*
Yes
No
If yes, please explain.
How will your child get to and from school?
*
Bus
Car
Other
Please list any sports or extracurricular activities your student currently participates in at their zoned school.
Inspire Virtual Academy Policies and Procedures
Please read the policies and procedures manual below. If you accept the terms and conditions, please sign below. If you cannot see the file below, copy and paste the link below into your browser.
Signature
*
Back
Next
Save
Additional information is required to complete your registration.
Please report to Inspire Academy and bring 2 different proofs of residency (Utility bills, other documents that verify that you live at the address noted in your application). You will also need to bring the student's birth certificate, current immunization records, and complete some additional paperwork required by Chambers County School District.
I understand what additional information is required.
*
Yes
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