Initial Virtual School Application

Initial Virtual School Application

Today's Date

Term of Requested Enrollment

Student Name

Date of Birth

Current Address

Contact Phone Number

Current Grade/Year in School


Parent/Guardian Name

Parent/Guardian Contact Phone Number

Parent/Guardian Email Address

What type of enrollment are you seeking?

Enrollment as a full-time student
Enrollment as a part-time student


Seeking NCAA eligibility?  

 Yes     No

Number of courses requested

Name(s) of course(s) being requested

Student is currently attending
 Public School
 Private School
 Home-Based School (Requires DPI Approval)

Name of School Currently Attending

Online Learning Readiness Checklist
After completing the checklist, count the number of times you selected "yes" or "no". If you answered "yes" to fewer than 10 statements, online learning may not be right for you. 

I am self-motivated and self-disciplined.
I am a good "time-manager".
I am comfortable with e-mail and word processing.
I can read analytically and critically.
If I set my sights on an end result, I usually achieve it.
I am confident in my academic abilities.
I do not give up easily, even when confronted with obstacles.
I believe I am responsible for my own education.
I am willing to try something new.
I am willing to work in a loosely structured environment.
I will not have conflicts with work, athletics or child care and school activities.
have convenient and frequent access to a computer with an Internet connection.


Explain how online learning will meet your educational needs. 

If you are applying as a part time student for a course that is also offered in a traditional setting, are there any extenuating circumstances?

Technology Requirements: 
Technical recommendations for the program are a High Speed Internet (Broadband) of 2 Megabytes or greater, a computer with a processor of 2.33 Ghz and 10 Gigs of available hard drive storage. It is recommended that students have a video web cam for communicating with teachers, but it is not required. Do you own a computer that meets these requirements already?

If denied, parents and guardians may appeal the decision of the review team to the District Administrator at 215 Pine Ave NE, Menomonie, WI 54751.

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