KLA School Year Registration Form
To be completed by Guidance Counselors only
Please complete 1 form for each student you wish to register for the KLA online learning program.
You will receive a confirmation email upon submission.
Was this student previously enrolled in KLA?
Student's First & Last Name:
Parent/Guardian Mailing Address
List required course(s) including: COURSE NAME, SEMESTER (if applicable), CREDIT (example: English 9 A half (0.5) credit)
*PLEASE contact KLA regarding World Languages
Is the student on an IEP? (If yes, please email a copy of the IEP to [email protected])
Case Manager/Intervention Specialist for this student:
Only answer if you answered yes to is this student on an IEP. Is student approved to attend KLA online learning by your Special Ed Director?
Is the student on a 504? (If yes, please email a copy of the 504 to [email protected])
Only answer if you answered yes to is this student on an 504. Is student approved to attend KLA online learning by your Special Ed Director?
Please provide any additional information on this student.
Please provide any specific completion dates for course(s) which you have agreed on with your student. For example: Algebra 1/A must be complete by 9/30/19.