Enrollment Forms Packet (EFP) at a glance
What it is: The Enrollment Forms Packet (EFP) of Agora Cyber Charter School is the paperwork required to complete this step in the enrollment process.
Notary: If you are not the guardian of the named student but support the student gratis, submit the Agora Notarized Statement.
What to bring and attach to Enrollment Forms Packet (EFP)
Proof of Age: Birth Certificate (not the hospital issued certificate). Provided by you.
Proof of Residency: Please submit one of the following: Current Utility Bill (gas, water, electric, sewage, cable or land line phone) with service address OR Valid Pennsylvania Driver's License OR Department of Transportation ID OR Mortgage statement/ Current Lease with signature OR Valid Vehicle Registration OR Property tax bill OR Deed.
Immunization Record: Current Immunization Record OR Immunization Exemption Form. Provided by you.
A filled-in Enrollment Forms Packet (EFP) example: a parent fills out the student information
How to fill out Enrollment Forms Packet (EFP), box by box
I. Student Information
I. Student Information: Last Name, First Name, MI, Home Address, City, State, Zip Code, County, Telephone, Mailing Address (If Different From Home Address), City, State, Zip Code, Date Of Birth, Age.
II. School District of Residence and Former School Information
II. School District of Residence and Former School Information: School District of Residence. Former School Information (Other Than Pre-School): Public School, Charter School, Home School or Nonpublic School; or Student Not Enrolled in School Preceding Enrollment in Charter School Because: Entering Kindergarten, Re-Enrolling Dropout or Other. Name of Former School, Address of Former School, Previous Grade, Withdrawal Date From Former School.
Was Your Child Receiving Special Education Services Based On An Iep? Yes No. If Yes, Do You Have The Child's Special Education Records (Iep)? Yes No.
Notification of Offense Form
Notification of Offense Involving Weapons, Alcohol or Drugs, Infliction of Injury to Another Person, or Any Act of Violence. Parental Registration Statement: Student Name, Date of Birth, Grade, Parent or Guardian Name, Home Address, Home Phone, Alternate Phone.
According to Pennsylvania Act 26 of 1995, the parent, guardian, or other persons having control or charge of a student shall, upon registration, provide a sworn statement or affirmation stating whether the pupil was previously suspended or expelled from any public or private school of this Commonwealth or any other State for an act or offense involving weapons, alcohol or drugs, or for the willful infliction of injury to another person or any act of violence committed on school property. The registration shall include the name of the school from which the student was expelled or suspended with the dates of expulsion or suspension.
Under Act 26 of 1995, any willful false statement made under this section shall be a misdemeanor of the third degree.
Please check the appropriate box and sign: if you indicate “Yes” please complete the remainder of this form and sign. YES, My child has been previously suspended or expelled OR currently is suspended or expelled from any public or private school of this Commonwealth or any other state for an act or offense involving weapons, alcohol or drugs, or for the willful infliction of injury to another person or for any act of violence committed on school property. NO, My child has not been previously suspended or expelled OR currently is suspended or expelled from any public or private school of this Commonwealth or any other state for an act or offense involving weapons, alcohol or drugs, or for the willful infliction of injury to another person or for any act of violence committed on school property. ** Please complete if your child has been or is presently suspended or expelled from another school. My child was suspended or expelled from the following school: Name of the school, Telephone, School Address, Suspension/ Expulsion Start Date (MM/DD/YYYY), Suspension/ Expulsion End Date (MM/DD/YYYY). Please provide additional schools and dates of expulsion or suspension on back of this sheet.
I make this statement subject to the penalties of 24 P.S. §13-1304-A(b) and 18 Pa. C.S.A. §4904, relating to unsworn falsification to authorities, and the facts contained herein are true and correct to the best of my knowledge, information and belief.
Reason for suspension/expulsion. Please check all that apply: Offense involving weapons, Offense involving alcohol, Offense involving drugs, Willful infliction of injury to another person, An act of violence committed on school property, Other.
Parent or Guardian Signature, Date.
More rules for Enrollment Forms Packet (EFP)
Charter School Student Enrollment Notification Form For School Year 1-1. By filling out this form, you have indicated your decision for your child to attend Agora and that your child will not be enrolled in another school while attending Agora. Provided in this packet. Warning: A child enrolled in another public school or a nonpublic or private school cannot, at the same time, enroll in a charter school, but is permitted to complete an application for enrollment while enrolled in other school.
III. Parent/Guardian Information: Child Lives With: Both Parents, Both Parents Alternately, Mother Only, Father Only, Legal Guardian, Foster Parents, Other Adult. Special Custodial Court Instructions: (If Yes, Please Provide a Copy of Court Order.) Yes No. Complete Parent/Guardian Name and Address Information As Applicable: Father's Name, Mother's Name, Address, City, State, Zip Code, Home Telephone, Work Telephone.
If The Student Is Not Living With Parents, Please Complete This Section.
Guardian's Name Or Foster Parent's Name Or Other Adult Name: Name, Address, City, State, Zip Code. My signature on this form indicates my decision to have my child attend the charter school named on page 1 of this form and signifies my request that appropriate school records be forwarded from the school district to the charter school. Signature of Parent/Guardian: Date.
Offense Form: Please note that you should only write an “X” in one of the blanks to indicate if your student was/ is or was/is not expelled or suspended. Only fill out the boxed section if it applies to your student. The form must be signed and submitted for all students. Provided in this packet.
Home Language Survey: Please read the directions for this form to ensure you answer the questions correctly. Provided in this packet.
Release of Records: By filling out this form, you are giving the school permission to request your student's official records from their previous school after the approval process. If your child is enrolling in Kindergarten or was Homeschooled please indicate it on the form, fill out the top portion and sign it. Provided in this packet.
Please accept this document as formal approval for the release of all official school records (including the record of transcripts, testing information, special education, health and immunization records).
The first three questions relate to your child's first language. Please do not include languages learned in school. School District, Date, School, Student's Name, Grade. 1. What is/was the student's first language? 2. Does the student speak a language(s) other than English? Yes No. If yes, specify the language(s). 3. What language(s) is/are spoken in your home? 4. Has the student attended any United States school in any 3 years during his/her lifetime? Yes No. Name of School, State, Dates Attended. Person completing this form (if other than parent/guardian): Parent/Guardian signature, Date.
Question four asks if your child has attended school in the United States for any three years. These years do not have to be consecutive. Please complete the name of school, state and dates attended for the most current schools your child has attended in the United States. These include preschool, private schools and home schooling.
Required for
Required for all 1st -9th Grade Students
Report Card: Please submit your student's most recent report card. Provided by you.
Required for all 10 -12th Grade Students
Transcripts: You will need to request a transcript from your student's current school, which will show your student's academic standing. This is required in order to place all 10th - 12th graders.
Required for student with an IEP or other Special Education needs
IEP: A copy of your student's current IEP (Individualized Education Plan). Because the IEP expires yearly, please submit the current IEP. Provided by you.
Evaluation Report: The Evaluation Report is valid for 3 years. If you do not have a copy of your student's ER, you can request a copy from your student's current school. Provided by you.
Required for students that have a 504 plan
504 Accommodation Plan: A copy of your student's current 504 Accommodation Plan. Provided by you.
Common questions about Enrollment Forms Packet (EFP)
Does it need a notary?
If you are not the guardian of the named student but support the student gratis, submit the Agora Notarized Statement.
Who signs it?
Home Language Survey: If someone other than the parent completed the form please note where it indicates. Please leave blank otherwise. The form is completed by the parent/guardian signing where indicated.
Where do I file it?
Important Note: Please send copies, do not mail the original documents. Fax (preferred): 1-866-529-0166. Scan and Email: agorafax@k12.com. Mail: Agora Cyber Charter School 2300 Corporate Park Drive Suite 200 Herndon, VA 20171.
What am I certifying when I sign?
My signature also certifies that my child is not, and will not be, enrolled in another public school, a nonpublic school or a private school at the same time he or she is enrolled in this charter school.
Sources
[1] Enrollment Forms Packet (EFP), Agora Cyber Charter School (the Official source link on this page).
