Simultaneous Hybrid Enrollment Form

Dear ABC Families,

This enrollment form is only for ABC families to enroll their child(ren) in the Simultaneous Hybrid Model for in-person learning at school. Please do not complete this form for children who will remain in the ABC Virtual Academy.

In the Simultaneous Hybrid Model, your child will be assigned to a Cohort, and attend school 2-days in-person (Cohort A: Mon./Tues. or Cohort B: Thurs./Fri.); 2-days online, and work independently on Wednesdays. To the extent possible, families will be assigned the same Cohort days.

Important Dates:

March 18, 2021 Enrollment begins
March 22, 2021 Enrollment ends at 12:00 p.m. (noon) (Updated timeline for high school only: Enrollment ends at 12 noon Tuesday, March 23)
On Thursday, March 25, 2021, parents/guardians of students in preschool, TK-8th, high school Phase I (students identified for additional support), and Adult Transition, will be notified of their Cohort offer. The deadline to accept the Cohort offer is Friday, March 26, 2021, at 6:00 p.m. These students will begin the Simultaneous Hybrid on April 12, 2021. (Updated timeline for High School Only: Friday, March 26, notification of cohort assignments, and families must accept the offer by Monday, March 29, at noon,)
On Monday, April 19, 2021, parents/guardians of high school students in Phase II (students not included in Phase I) will be notified of their Cohort offer. The deadline to accept the Cohort offer is Tuesday, April 20, 2021, at 6:00 p.m. High School students in Phase II are tentatively scheduled to begin the Simultaneous Hybrid on April 26, 2021.

To fully review the Simultaneous Hybrid Model of in-person learning at school click here.

For technical assistance contact the ABC tech support line at 562-689-7299 from 8:30 AM-4:00 PM. Monday through Friday. Contact your school office for an alternative option to completing this form online.

Parent/Legal Guardian of Record

Last Name *

First Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address

Enroll each child into the Simultaneous Hybrid Model below.

Student 1

Last Name *

First Name *

Student ID# * 🛈

Birth Date (Format example 10-06-2004) * +

Current School *

Current Grade *

I understand that I am choosing to enroll my child in the Simultaneous Hybrid *

YES

Current Special Programs (Check if YES)

My child has an IEP (Individualized Education Plan)

Prior to COVID, my child rode the bus to school, and will need bus transportation

My child is in the Dual Immersion Program

My child will eat a school-provided lunch

Extended Learning Childcare Program

Would you like to enroll another student in the Simultaneous Hybrid? *

Yes

No