Wichita Public Schools

Learning2 eSchool of Wichita

Pre-Enrollment Form

STUDENT INFORMATION

 

 
       
Student Legal Name:
  Last First MI                                Maiden
Student Address:
  Street Address     City Zip Code

 Student Contact Information: 

Current School Attending:

Day Phone (No Dashes)

Evening Phone (No Dashes)


Email Address


Date of Birth (MM/DD/YYYY)
Age
Grade

 

 

 

 

 

 

 

PARENT/GUARDIAN INFORMATION

 

 
     
Name Relationship Email Address Day Phone (No Dashes) Evening Phone (No Dashes)
Name Relationship Email Address Day Phone (No Dashes) Evening Phone (No Dashes)
     

TECHNOLOGY QUESTIONS

 

 
     
Do you have Internet at home?     Yes, Cable           Yes, DSL          Yes, Broadband Card (Sprint, Cricket)          Yes, Dial-Up       No Internet at home
 
Would you need to check out a computer from us?  Yes             No
   

INTEREST

 

 

 
 
Why are you interested in attending a virtual school?