August 201 Palm Beach Virtual School Interest Survey
This information is required to determine eligibility for virtual courses in grades 6 - 12.  
Parents will be notified of acceptance via e-mail or phone.
If accepted, each student and a parent/guardian is REQUIRED to attend a face-to-face orientation.

ADMISSION TO PALM BEACH VIRTUAL SCHOOL AS A FULL TIME STUDENT IS NOT GUARANTEED.
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Are you choosing to seek full-time enrollment in grades 6 - 12 beginning August 2017? *
Full-time students are required to take all standardized tests. The parent is responsible for transportation to the zoned school. *
What online program interests you most?   *
Information sessions were held in June and July.  Click on the links describing courses for more information.  YOU DO NOT NEED TO SELECT ANYTHING HERE:)
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Student's First Name *
Student's Last Name *
Student's Date of Birth *
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Student's Palm Beach County Student Number
Last grade completed *
Name of last school attended *
City of last school attended *
State of last school attended *
Last attendance date *
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Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Email Address *
Parent/Guardian Phone Number *
How did you hear about Palm Beach Virtual School? *
What is the primary reason you are interested in full-time online education for your child? *
Is your child reading on or above grade level? *
Is there an Individual Educational Plan (IEP), 504 plan other other needed accommodations for your child? *
Add additional accommodation here
If you would like to provide additional information, please enter it in the space below.
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