Virtual Enrollment
Form LL
District: School Year:
Bldg/Program: Count Date:
Instructions: Complete this form for all pupils enrolled in virtual high school classes. No more than two (2) classes may count toward pupil
membership (Pupil Accounting Manual Section 50-1)
Enrolled in In
H.S. Credit Traditional On-Site Mentor Attendance on FTE For Total
Pupil Name Grade Granted Course Title (s) Courses Teacher Name Count Day Virtual FTE
Y/N Y/N Y/N Class
1
2
3
4
5
6
7
8
9
10
I certify this is a true and accurate list of pupils enrolled in virtual classes.
Signature/Title of Authorized Representative Date
12/12/2011