MEAD OPTIONS INTEREST FORM (one form per student)
Please take the time to fill out the form below.  When an appropriate opening becomes available within the program selected, we will contact you with more information.  We are working on enrolling students for the 2024-2025 school year.
Email *
STUDENT LAST NAME: *
STUDENT FIRST NAME: *
Student's DATE OF BIRTH:  MM/DD/YYYY *
Enrollment requested for... *
GRADE: Which grade will your student be in chronologically, for the year of enrollment? (unrelated to academic achievement or credits) *
PARENTS; Name(s) *
Parent email *
Parent cell phone *
OVERVIEW OF MEAD OPTIONS PROGRAMS: Please read about the programs below before continuing.
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Please carefully consider the choices above, and indicate which program you are interested in for your student? (Some programs may be currently full or have a waiting list.) *
Help us to understand what it is about your child/family that the has lead your family to seek a change in educational setting? 
 *
Current school(s) (or homeschool) *
Additional previous schools and districts (list all) *
Do you live within the Mead School District? *
EXPERIENCE: Do you have any experience with the type of learning program you selected above? Please explain. *
ADULT AVAILABILITY: Will there be an adult home during the school day for instruction or supervision of instruction?  Please explain. *
GRADES: How are your student's grades in the current school. *
STRENGTHS:  Describe the strengths your child may have in a learning environment. *
SUPPORTS:  Describe the struggle points your child may have in a learning environment. *
Required
How has your child demonstrated the ability to learn successfully in the setting you have chosen? *
We will be contacting your previous school(s), is there anything we need to know?   *
I authorize the staff of our previous/current school to speak with the staff of the Mead Options program(s) selected, regarding my student’s experience at the current/previous school. *
Required
I understand the Prohibition on Re-Disclosure: This information has been disclosed to the named individual(s) from records whose confidentiality is protected by Federal Law. Federal Regulations (FERPA and ADA) prohibits making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by such regulations. A general Authorization for the release of medical or other information is not sufficient for this purpose. *
Required
In accordance with FERPA, I, the parent of the student listed above, hereby authorize the previous/current school(s)  to release information from the student’s education record to the staff of the Mead Options Program(s) for the reasons specified. I acknowledge by my signature that I understand, that although I am not required to release my information, I am giving my consent to do so. Additionally, I understand that I may revoke this authorization in writing at any time, except for that information which has already been released with consent and prior to my revocation. *
Required
SIGNATURE and DATE for authorization for release of confidential information. *
STATEMENT OF UNDERSTANDING: I understand that every the Mead Learning Options program is a public school of choice that operates under the mandates of Washington State law governing Alternative Learning Experience (ALE) programs.  It is NOT an entitlement and is NOT independent homeschooling. These programs do not currently have regular bus transportation.

Enrollment is based on a parent's ability to be an active partner in their child's education and abide by the ALE laws.
* A written student learning plan (WSLP) is set up for each student that outlines the course, curriculum materials and what determines satisfactory  progress.
* Families can access an extensive library of district and building approved materials.
* No Mead Options Programs can purchase or supervise the use of any curriculum/materials that are faith-based.
* During the hours of instruction covered by the WSLP, only approved curriculum may be used.
* Students must make weekly contact with a certificated teacher.
 *
Do you have any questions? *
You will receive a confirmation that we have logged your interest form.  A staff member will contact you (usually by email) within the next 1-14 days.  *
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