Indiana Online | Create New Account

Student Account Creation Form:

Complete and submit our account creation form. After saving the form, you will receive login information to the email addresses entered below. If possible, do not use a school email address. Emails from our system could be blocked. For questions or issues, please use this link. https://indianaonline.org/contact-us/

Student Information

Student First Name *

Student Last Name *

Student Middle Name

Gender *

Date of Birth *

Grade Level *

Student Receives Accommodations via an IEP/504/ILP *

School *

Counselor *

Local Student ID Number

Notes

Address

Street *

City *

State *

ZIP *

Email *

Confirm the student email *

Phone Type *

Phone *

Race *

Primary Parent/Guardian Information (With Whom the Student Resides)

Relationship

Primary Guardian Last Name *

Primary Guardian First Name *

Phone *

Email *

Confirm the Guardian Email*

Alternate Parent/Guardian Information

Relationship

Alternate Guardian Last Name

Alternate Guardian First Name

Phone

Confirm the Guardian Email