Checklist for requesting Virtual Learning for your child:

● Request an attendance record and report card from your child’s school for

the 2020-2021 school year. These reports are required and must be submitted to the physician at the evaluation visit to have a completed packet.

● Complete the Parent Request for Virtual Learning application. A virtual learning packet may be downloaded from the Bladen County School’s (BCS) website, https://www.bladen.k12.nc.us/ or pick up from your child’s school.

● Submit the following documentation to your child’s school by October 8,2021:

● Completed Parent Request for Virtual Learning application. ● Completed Bladen County Schools Virtual Learning Medical Evaluation for

Individual/Family/Caregiver COVID Risk ● Please note that an office visit must be scheduled with your physician to have the

medical evaluation ● Parent Permission Form for Virtual Learning

The deadline for completed application and medical evaluation forms is October 8, 2021. The virtual learning request will be reviewed by the BCS Virtual Learning Committee and families will be notified of the status of the request.

Planned Virtual Learning Program for 2021-2022 School Year

General Information:

● Parents may complete a request for virtual learning for their child(ren). There must be a separate application for each child. The request will be reviewed by the BCS Virtual Learning Committee, and families will be notified of the status of the request via mail, phone call or email.

● Students will be considered based on medical need: ○ Student has an underlying condition that increases the risk for severe illness from COVID-19, OR ○ The student resides with someone, or a student’s caregiver, who is at an increased risk for severe

illness from COVID-19 due to an underlying medical condition. ● A medical evaluation form, completed by a physician, will be required. This evaluation must be a

scheduled office visit with your medical provider. ● An attendance report and a copy of the student’s report card from the 2020-2021 school year must be

submitted to the physician at the time of the medical evaluation visit. ● The total number of students participating in virtual learning will not exceed 10% of our average daily

membership (ADM) for the district. What you can expect for the elementary and middle school planned virtual learning program:

● Each student will follow their class schedule and will attend virtually in a synchronous (at the same time) learning format. The teacher will provide feedback on completed assignments in the same manner as the face to face classroom.

○ Students will attend virtually the entire school day with their webcam enabled. ○ Students will attend virtually in their school uniform. ○ A parent, guardian, or responsible adult (age 21 or older) must be present the whole school day to

facilitate the students' learning while they are virtual. ○ Students must have a conducive environment to participate in virtual learning that is free of

distractions. ● Students will receive virtual instruction via video and audio for synchronous learning daily. The student

will receive reading, math, science and social studies as their core curriculum along with art, music, physical education, etc. virtually by the teacher of record. Instruction will include daily aligned assignments for students to complete and submit for a grade for each content area through our Learning Management System (LMS), Canvas. Other assignments, tests, and projects will be assigned and posted electronically into Canvas in the same manner as the face to face instruction.

● Students will log in to Canvas each day to attend class virtually to access their assignments and other instructional materials.

● Students will also complete the Canvas check-in daily for each class to be counted present. ● Students will attend the whole school day virtually.

● Teachers will monitor and respond to student emails during their regular work day. Please allow 24 hours for a response. On school days, emails received after 3:00pm on Fridays will be responded to by 12:00pm on Monday.

● Synchronous learning will provide the opportunity for live instruction that will follow the student’s schedule. The teacher will provide feedback and support during the synchronous learning and may also provide assistance during other scheduled times.

● Students must complete all required assignments and submit these as directed by the assigned teacher. ● Grades and feedback will be provided on submitted assignments in the same manner as face to face

instruction. ● EC, EL, Migrant, and AIG services will be provided. Your child’s AIG, EL, Migrant, and/or EC teacher

will communicate details of this service with you directly. ● Based on medical evaluation documentation, extracurricular activities and sports may not be an option. ● Assignments must be completed and submitted by teacher’s assigned due date. Assignment grades will be

posted in PowerSchool and Canvas. Feedback will be provided as appropriate. ● Students will be assigned virtual learning for a 9-week period and their placement will be reviewed each

grading period thereafter. ● Progress reports will be submitted every 3 weeks. ● Every three weeks an academic notice will be sent to the parents and/or guardian if the student is not

making adequate progress. Students not making adequate progress may be returned to face-to-face instruction at any time.

● A high-speed Internet connection is required for the student to be considered for virtual learning. There is not an option for paper packets for this program.

● The student must have access to a device to be considered for virtual learning. ● The student will be required to attend in person for End-of-Grade, Check-Ins, and all Diagnostics

assessments. Arrangements for taking these assessments will be scheduled with the principal. ● If a student has excessive absences or failing grades, then the Virtual Learning Committee and the

principal will meet to review the data and consider next steps for the student. The Parent Request for Virtual Learning for the Second Nine Weeks must be submitted by October 8,2021. Families will be notified regarding their request. What you can you expect for high school planned virtual learning program:

● Each student will follow their class schedule and will attend virtually in a synchronous (at the same time) learning format. The teacher will provide feedback on completed assignments in the same manner as the face to face classroom.

○ Students will attend virtually the entire school day with their webcam enabled. ○ Students will attend virtually in their school uniform. ○ A parent, guardian, or responsible adult (age 21 or older) must be present the whole school day to

facilitate the students' learning while they are virtual. ○ Students must have a conducive environment to participate in virtual learning that is free of

distractions. ● Courses through Bladen Community College are not a virtual learning option unless designated by the

college. ● Career and Technical Education course options through BCS will be limited in nature due to the hands-on

learning assignments and field experiences necessary for these pathways.

● Students will log in to Canvas each day to attend class virtually to access their assignments and other instructional materials.

● Students will also complete the Canvas check-in daily for each class to be counted present. ● Students will attend the whole school day virtually. ● Teachers will monitor and respond to student emails during their regular work day. Please allow 24 hours

for a response. On school days, emails received after 3:00pm on Fridays will be responded to by 12:00pm on Monday.

● Synchronous learning will provide the opportunity for live instruction that will follow the student’s schedule. The teacher will provide feedback and support during the synchronous learning and may also provide assistance during other scheduled times.

● Students must complete all required assignments and submit these as directed by the assigned teacher. ● Grades and feedback will be provided on submitted assignments in the same manner as face to face

instruction. ● EC, EL, Migrant, and AIG services will be provided. Your child’s AIG, EL, Migrant, and/or EC teacher

will communicate details of this service with you directly. ● Based on medical evaluation documentation, extracurricular activities and sports may not be an option. ● Assignments must be completed and submitted by teacher’s assigned due date. Assignment grades will be

posted in PowerSchool and Canvas. Feedback will be provided as appropriate. ● Students will be assigned virtual learning for a 9-week period and their placement will be reviewed each

grading period thereafter. ● Progress reports will be submitted every 3 weeks. ● Every three weeks, an academic notice will be sent to the parents and/or guardian if the student is not

making adequate progress. Students not making adequate progress may be returned to face-to-face instruction at any time.

● A high-speed Internet connection is required for the student to be considered for virtual learning. There is not an option for paper packets for this program.

● The student must have access to a device to be considered for virtual learning. ● The student will be required to attend in person for End-of-Course and Check-Ins. Arrangements for taking

these assessments will be scheduled with the principal. ● If a student has excessive absences or failing grades, then the Virtual Learning Committee and the

principal will meet to review the data and consider next steps for the student. The Parent Request for Virtual Learning for the Second Nine Weeks must be submitted by October 8,2021. Families will be notified regarding their request.

Application for Planned Virtual Learning Program Please complete the application in its entirety. A licensed physician/medical provider must complete the BCS Remote Learning Medical Evaluation form to be submitted with this application.

Student Name:

Date:

Address:

Parent/Guardian(s)

Contact Phone Numbers:

1.

2.

Parent Email Address:

Assigned School:

● My child has an underlying condition that increases the risk for severe illness from COVID-19. ● My child resides with someone, or my child’s caregiver, is at increased risk for severe illness

from COVID-19 due to an underlying medical condition. Documentation from a doctor’s office of this risk must be provided to your child’s medical provider at the time of the child’s medical evaluation office visit.

If the student or caregiver has an underlying condition, what is the diagnosis of the medical condition?

How does it affect the student’s ability to attend school face-to-face? Describe how the student will be able to complete their assignments/academics while at home.

Does the student have access to a computer and high speed internet for virtual learning? Name of the adult that will be present while the student is attending his/her class schedule daily.

I understand that this is the process used by Bladen County Schools to self-identify a student, family member, or caregiver as high risk for COVID-19 and that this process is used to develop a virtual learning plan for my child. Completion of application does not guarantee that your child will be allowed to attend virtually.

Parent Signature:

Date:

Bladen County School Virtual Learning Medical Evaluation

Individual/Caregiver COVID Risk To be completed by student’s physician/provider: Student’s Full Name: DOB: Age:

School: Grade: Sex:

Parent/Guardian’s Name:

Home/Cell Phone #: Work #: Emergency #:

Physician’s/ Provider’s Name & Address:

Please check the reason for the Virtual Learning request:

● The student has an underlying condition that increases the risk for severe illness from COVID-19. Please describe _______________________________________________

● The student resides with someone, or the child’s caregiver, is at increased risk for severe illness from COVID-19 due to underlying medical conditions. Please describe ________________________________________________

Given your assessment of the student and the family risk of COVID-19 exposure, it is your medical recommendation that the student is: (Please check applicable statement)

● Able to attend in-person learning ● Unable to attend in-person learning

● Able to participate sports/extracurricular activities

● Unable to participate sports/extracurricular activities

● I have reviewed the student’s attendance record and report card for the 2020-2021 school year.

Provider’s Printed Name: ______________________________________ Phone: ___________ Provider Signature:__________________________________________ Date:_____________

Bladen County Schools

Parent Permission Form for Virtual Learning

Name of Student (print legibly): ______________________________________________________ Student Grade Level:_________ School: __________________________________________________ Contact Number #: ____________________________________ (please circle - Home or Cell Phone)

Check all that apply:

● I acknowledge that I have a high-speed Internet connection. ● I acknowledge that my child has a device to use daily. ● List the name of the adult that will be present during the school day (age 21 or older):

● I understand that meal delivery will not be provided during the school day. ● I understand that transportation will not be provided to and from the school. ● I understand that my child will have to wear his/her uniform everyday while they are virtual. ● I understand that my child will be required to attend in person for End-of-Grade, End-of-Course

and/or NC Check-Ins. Arrangements for taking these assessments will be scheduled with the principal.

● I understand that my child’s progress will be reviewed every 9 weeks. If his/her progress is not satisfactory, the District Committee could terminate my child’s virtual learning option.

Please check below to indicate the participation of your child.

● I do give permission for my child to participate in BCS Virtual Learning. ● I do not give permission for my child to participate in BCS Virtual Learning.

Parent/Guardian Signature:

Parent/Guardian Name Printed:

Date:

Bladen County Schools

Principal Recommendation for Student to Participate in Virtual Learning The Principal will review the following from the 2020-2021 school year. Student Name: _____________________________________ PowerSchool# _____________________

Record Details

Attendance

Grades

Past Performance on Virtual if Applicable

EC, 504, EL, Migrant and/or AIG Identification

Does the student receive Tier II or Tier III interventions?

Comments:

● Approved for Virtual Learning ● Not Approved for Virtual Learning

Principal Signature:

Date:

Bladen County Schools

Virtual Learning Committee Approval Form for Student The Virtual Learning Committee will review the following: Student Name: ______________________________________ Date: ___________________ PowerSchool # _____________________

Notes

Principal’s Recommendation

Student’s Application

Medical Evaluation

Attendance for 20-21

Report Card for 20-21

Internet Required

Device Required

Adult Present at the home

Special Population Status

Comments:

Signature Title Approval Status

Chief Academic Officer ● Yes No

Chief Operations Officer ● Yes No

Lead Nurse ● Yes No

Director of Student Services/SEL ● Yes No

Director for Exceptional Children ● Yes No

Virtual Learning Committee Minutes

Student Name: _________________________________ Powerschool #: ______________________

Signature Title Approval Status

Chief Academic Officer ● Yes No

Chief Operations Officer ● Yes No

Lead Nurse ● Yes No

Director of Student Services/SEL ● Yes No

Director for Exceptional Children ● Yes No

Virtual Learning Committee Minutes Page 2