PARK HILL SCHOOL DISTRICT
**ONLINE COURSE ENROLLMENT FORM: GRADES 10 – 12 ONLY**(3.31.15)
Due May 15, 2015
10 11 12
(Student Name)
(PHSD email)
(Grade Level- Fall of 2015)
(School ID#)
(Street)
(City)
(State)
(Zip)
(Cell Phone)
(Home Phone)
(Counselor’s Name)
(School)
Please check the following boxes if applicable:
I receive special education services and have an IEP.
I receive ELL services.
I receive modifications or accommodations under a 504 plan.
I participate in the Gifted program.
Virtual Academy Classes
Dates/Times
Location
June 1 – June 19
8:45 – 1:15 PM
June 22 – July 10 (no class July 3)
8:45 – 1:15 PM
Park Hill & Park Hill South
(Students will attend their home schools)
Summer School Online Course Description
Students have an opportunity to earn ½ credit or 1 credit after
successfully completing 120 hours of course instruction and
learning activities. Students will attend their respective home
schools (Park Hill or Park Hill South) for orientation, blended
instruction and end of course exams.
Online-blended courses are taught by certified teachers and meet
the same national, state and district standards as other Park Hill
course offerings. During the course, teachers communicate with
students using Park Hill student email, phone, and collaborative
tools within the course management system.
During the summer school session, students must meet face-toface with their instructor four times. Students will attend an
onsite orientation (June 1st), two face-to-face onsite sessions with
their instructor (dates provided by teacher), and the onsite
final/end of course exam (dates provided by teacher).
Students who are unable to attend the on-site orientation on
June 1st, the two mandatory onsite blended sessions, and the
required on-site End of Course/final exams should not enroll in
the online-blended courses offered during the 2015 Summer
School Session. No exceptions to this requirement will be
allowed.
Online-Blended Courses Requirements
Students participating in an online course must:






Have access to a computer with Internet connection (onsite
computer option available)
Attend an onsite course orientation on June 1st at 7:30 AM
Log into the course management system daily and actively
participate in course instruction
Check district email daily
Attend two out of the five face-to-face onsite sessions
(dates/times provided during orientation)
Attend onsite Final/End of Course Exam
Virtual Advancement Courses
Students need to place a number by each course using “1” as first choice, “2” as second choice, “3” as third choice.
CHOICE
(1, 2, 3)
COURSE TITLE
TECHNOLOGY ACCESS –
Select One
R=Remote Access: Use of Home computer
O=Onsite Access: Use of computer on
campus
Completion of
these courses = 1
CREDIT
ACT Prep
R 
O 
American History
R 
O 
Psychology
R 
O 
Personal Finance and Computer Applications
R 
O 
Animation/Game Design (Prerequisite-Computer Science)
R 
O 
Creative Writing
R 
O 
Enriched ELA III
R 
O 
Government
R 
O 
Marketing Concepts
R 
O 
English
Language Art
Elective
English
Language Art
Social Studies
Required
Course
Practical Art
Marketing Internship (Instructor approval)
R 
O 
Practical Art
Health & Personal Wellness
R 
O 
½ Health &
½ Practical Art
General
Elective
Social Studies
Required
Course
Social Studies
½ Personal
Finance &
½ Practical Art
Practical Art
The following courses are offered as ½ credit courses.
CHOICE
(1, 2)
COURSE TITLE
Session #1
6/1 – 6/19
8:45–1:15 PM
Session #2
June 22 – July 10
(no class July 4)
8:45–1:15 PM
Completion of
these courses =
½ CREDIT
Health (State of MO requirement for diploma)
R 
O 
R 
O 
½ Health
Personal Wellness (requirement for diploma through class of 2017)
R 
O 
R 
O 
½ Practical Art
________________________________________________________________
Student Signature
___________________________________________________
Date
________________________________________________________________
Parent Signature
___________________________________________________
Date
________________________________________________________________
Counselor Signature
___________________________________________________
Date
*Transportation will be provided for summer school. Please indicate if your student will be utilizing the transportation and please provide the current
bus number. □ Yes, transportation will be utilized. Current bus number is ______________.
□ No transportation needed.