Virtual Academy Application

The SCH Virtual Academy is currently not accepting enrollments for the 2021 Spring Semester. Applications for the 2021-2022 school year can be submitted after June 3rd.

Student Last Name First Name Middle Name
Date of birth Date of birth / MM / DD YYYY
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Student Phone # Student Phone # - ### - ### ####
Student Email
Grade
Special Education IEP

Special Education IEP Yes No
504

504 Yes No
Previous School - Name of School
Has your child been expelled or suspended in the past school year?
Which Hammond school would be the student's homeschool?
Parent / Guardian #1 -
REQUIRED
Last Name First Name
Relationship to Student:

Relationship to Student: Mother Father Legal Guardian Other
Student lives with this parent/guardian:

Student lives with this parent/guardian: Yes No
Primary Phone # Primary Phone # - ### - ### ####
Cell Phone # Cell Phone # - ### - ### ####
Work Phone # Work Phone # - ### - ### ####
Employer
Email
Parent / Guardian #2 -
REQUIRED
Last Name First Name
Relationship to Student:

Relationship to Student: Mother Father Legal Guardian Other
Student lives with this parent/guardian:

Student lives with this parent/guardian: Yes No
Primary Phone # Primary Phone # - ### - ### ####
Cell Phone # Cell Phone # - ### - ### ####
Work Phone # Work Phone # - ### - ### ####
Employer
Email
Please indicate if there is a special circumstance for appling to the Virtual Academy. Approval must come from Student Services.
The following applies to High School students ONLY
Do you plan to participate in extra-curricular activities?

Do you plan to participate in extra-curricular activities? Yes No
The family is responsible for providing transportation to and from extra curricular events.
School City of Hammond Schools follows the Indiana High School Athletic Association (IHSAA) eligibility rules in
regard to virtual students. Information regarding the rules may be obtained at www.IHSAA.org.
Do you plan to participate in sports?

Do you plan to participate in sports? Yes No
Parent Statement: Please sign below to authorize School City of Hammond officials to contact your current school of legal settlement or prior school attended for further information for the child listed in this Virtual Academy application. Also, it is understood that we, as parents, must assume responsibility for adequate transportation and supervision to and
from school. We certify that we have read and agree to the above terms of the School City of Hammond.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Spam Protection. Please answer this simple question:
In the number 73627, what is the 3rd digit?

Virtual Academy Application

Virtual Academy Application

Parent / Guardian #1 - REQUIRED

Parent / Guardian #2 - REQUIRED

The following applies to High School students ONLY

The family is responsible for providing transportation to and from extra curricular events. School City of Hammond Schools follows the Indiana High School Athletic Association (IHSAA) eligibility rules in regard to virtual students. Information regarding the rules may be obtained at www.IHSAA.org.

Parent / Guardian #1 -
REQUIRED

Parent / Guardian #2 -
REQUIRED

The family is responsible for providing transportation to and from extra curricular events.
School City of Hammond Schools follows the Indiana High School Athletic Association (IHSAA) eligibility rules in
regard to virtual students. Information regarding the rules may be obtained at www.IHSAA.org.