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ESC of Medina County Virtual Academy Registration Form
The Educational Service Center of Medina County will be the leader in fostering positive partnerships within our community by providing services and support that promote excellence in education.  Through a collaboration with Medina County School Districts we hope to provide a synchronous and interactive online educational environment for K-8 students.  Students will have the opportunity to continue online learning with a full-time classroom teacher while remaining a student of their home district. 

Student Last Name
Student First Name
District of Residence
It is required that all students be enrolled in their District of Residence before being admitted to the ESC of Medina County Virtual Academy. Are you currently registered to atted school in your district of residence?
Grade Level for 2021-22 School Year
Parent/Guardian Full Name
Student Address
Postal Code
Primary Phone
Why would you like for your child to attend this virtual academy?
These next several questions are your Parent Agreement and Student Contract Acknowlegement of Expectations. Please read the questions carefully and respond to all questions.
I understand that it is my responsibility and I agree to provide adequate internet service for the entire school year.
Do you need assistance obtaining internet access? If yes, a school district employee will contact you)
I understand that my child will be required to attend teacher-led, online learning sessions. I understand that it is my responsibility to ensure that my student is on time for these sessions and attends regularly.
I understand that I am requesting to enroll my student in a program provided by the ESC of Medina County through a partnership with my home school district. As such, my student will still need to meet mandated residency, attendance, and testing requirements.
I understand that full participation in all state-mandated testing is expected on the required dates. I will need to provide transportation to the testing site for state testing as required.
ATTENDANCE POLICY Teachers mus conduct attendance checks for each student on a daily basis. It is required for a number of statutory and regulatory requirements, as well as to gauge student well-being.
Studens are expected to log on and participate in the synchronous (live) portion of each of their scheduled classes according to the remote learning bell schedule.
Attendance will be taken during this synchronous instruction time. If a student is unable to attend the class synchronously, the teacher will follow up to determine the reason(s).
Students who are unable to attend the class synchronously may be marked present for the class if they have a meaningful engagement with the day's learning activity(ies) online asynchronously.
IMPORTANT NOTICE If a student misses two classes in a row during the class synchronous session, then a phone call home will occur. If the student continues to miss the synchronous sessions and not complete their work, then further action will take place with the Virtual Academy administration.
I have read and understand the Attendance Policy
Parent Signature (by typing your name below, you are signing this contract electronically. You agree that your electronic signature is the legal equivalent of your written signature on this contract.
Your Name:
Your Email:

To validate your submission, please answer the following math problem:

captcha math problem
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124 W. Washington St.    |     Medina, OH 44256    |     Phone: 330.723.6393    |     Fax: 330.723.0573    
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