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GUIDANCE COUNSELORS

K'nextions Learning Academy Student Enrollment Form

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. 

Enrollments processed through this form will be billed to the SCHOOL DISTRICT.
 
If the fee for summer school enrollment is the responsibility of the student's family, registration should be completed by families beginning May 3, 2021 through the form found on the KLA Summer School-PARENT/GUARDIANS page of the KLA website.
 
You will receive a confirmation email upon submission. 

Select Your District (If your School/District is not listed click Other and PLEASE INCLUDE your School/District name on the last question of this form)












Counselor Name:
Was this student previously enrolled in KLA?
Student's First & Last Name:
Please select student's grade level






Parent/Guardian Name:
Parent/Guardian Mailing Address
Parent/Guardian Phone:
Parent/Guardian Email:
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 this class original credit or credit recovery?

Is the student on an IEP? (If yes, please email a copy of the IEP to [email protected])
IF you answered Yes to student on IEP then who is 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 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.
Please provide any additional information on this student or for this enrollment.
Your Name:
Your Email:

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

captcha math problem