Enrollment Pre-registration

Thanks for taking the first step towards becoming part of something big—the Florida Virtual Program! Fill out the form below to pre-register for enrollment. You will receive notification once a program is available and enrollment is open. Completing this form does not obligate you to enroll once a program is available in your district.

Note: All information you provide is protected by our privacy policy.

*First Name:

*Last Name:

*Address Line 1:

Address Line 2:

*City:

*State

*Zip

*Phone:

*Email Address:

What grade(s) will your children be attending in the 2010-2011 school year?

Pre-K	Kindergarten
1st Grade	2nd Grade
3rd Grade	4th Grade
5th Grade	6th Grade
7th Grade	8th Grade
9th Grade	10th Grade
11th Grade	12th Grade

*Number of students you are interested in enrolling for the 2010-2011 school year:

*What school district do you reside in?

What is your current method of schooling?

Florida Virtual Program
9951 Atlantic Blvd. Suite 319, Jacksonville, FL 32225 | Phone: 904.721.0035