[email protected]

(765) 528-2101

Central Indiana Virtual Academy

Jr./Sr. High New Student Enrollment

Student First Name *

Student Last Name *

Email *

Today's Date *

Date of birth *

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Address

Street Address *

City *

State *

Country *

Postal code *

Township

Student's Previous School *

Health Concerns/Other *

Does your student have an Individualized Education Plan (IEP)? *

Yes

No

Does your student have a 504 plan? *

Yes

No

Did your child play sports in the last 12 months at their previous school? *

Yes

No

Can we share your student's demographic information with military recruiters? *

Yes

No

Parent(s)/Guardian(s) *

Name of Parent(s)/Guardian(s) *

Parent / Guardian Emails *

Parent / Guardian Phone Number *

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone *

Thank you.

We also need a copy of your child’s birth certificate, Social Security card, proof of residency and immunization records to enroll. If your child's previous school does not provide us with the above listed items. You will need to bring them to the Jr./Sr. High School office or fax the documents to: 765-528-2276. Students cannot start school without these documents.

Have questions? Call Julie Shuler, Jr./Sr. High School Administrative Assistant at 765-528-2222 ex. 227 or please leave a voicemail.

Address:

Central Indiana Virtual Academy 

6760 State Road 42, Eminence, IN 46125

[email protected]

(765) 528-2101

Central Indiana Virtual Academy

Address:

Contact
Phone: (765) 528-2101
Email: [email protected]

Terms and Conditions

Privacy Policy

[email protected]

(765) 528-2101

Central Indiana Virtual Academy

Address:

ContactPhone: (765) 528-2101Email: [email protected]

Terms and Conditions

Privacy Policy

Contact
Phone: (765) 528-2101
Email: [email protected]