APPLICATION FOR ADMISSION

NOTE: In addition to submitting this application form, please download the full application packet and return requested materials, save for the division-specific application forms included in the packet.

Prefer to fill out the application by hand and mail it in with application fee? A pdf version of the application can be downloaded here).

Please be sure to save your in-progress form periodically in order to prevent data loss should a broswer error occur. The save button is located next to the submit button at the bottom of this form.

Please upload a recent photo/headshot of the applicant here:*

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Please ensure applicant's face is clearly visible and prominent in photo.

Please select the desired location:*

Bridges Los Angeles (Grades 4-12)Bridges Seattle (Grades 4-12)Bridges Academy Online (Grades 9-12)

Please select the desired division:*

Grades 9-12 (High School)Grades 7-8 (Middle School)Grades 4-6 (Phoenix Program)

For which academic year are you applying?*

2022-2023 (including spring 2023 semester)2023-2024

Please select the desired location and division:*

Name (First, Middle, Last, Suffix)*

Nickname

Street Address*

City*

State*

Zip*

Home Phone*

Mobile

Student Email Address*

DOB (mm/dd/yy)*

Birthplace*

Gender*

Ethnicity(ies)

(Optional: Used for statistical purposes only)

Current Grade:*

Applying for Grade:*

Plan to Enroll:*

Immediate/Mid-YearStart of Next Academic YearOther

Plan to Enroll:*

Term/Year

Name of Current School*

Phone Number*

Street Address*

City*

State*

Zip*

Head of School/Principal/Director*

Other schools attended:

Name of School*

City/State*

Phone*

Grade(s)*

Dates*

Name of School

City/State

Phone

Grade(s)

Dates

Name of School

City/State

Phone

Grade(s)

Dates

Has the applicant applied to Bridges Academy previously?*

YesNo

If yes, what academic year(s)?

For which grade(s)?

How did you hear about Bridges Academy? (Please be as specific as possible)*

What are the applicant's strengths, talents, interests, and skills both in and out of school? Include clubs, classes, or organizations your child has been involved in.*

What makes traditional school settings difficult for your child? Please address ongoing social/emotional, academic, and medical concerns separately.*

When, and under what circumstances, do you see your child thrive?*

List any educational therapy, psychotherapy, social skills, tutoring, or other support the applicant currently receives.*

Has the applicant ever been suspended, expelled, or counseled out from any school or been subject to disciplinary action?*

YesNo

Has the applicant ever been suspended, expelled, or counseled out from any school or been subject to disciplinary action?*

YesNo

Please describe:*

Has the applicant had an IEP and/or 504? (not required for admission) If yes, please provide.*

YesNo

Has the applicant had an IEP and/or 504 (not required for admission)? If yes, please provide.*

YesNo

Has the applicant undergone any specialized evaluations? (Neuro-psych, IQ, speech, educational or other assessments)

Has the applicant undergone any specialized evaluations? (Neuro-psych, IQ, speech, educational or other assessments)*

YesNo

If yes, please provide.*

YesNo

Does your child have a diagnosis of dyslexia?*

YesNo

If yes, how has their dyslexia been described?*

MildModerateSevere

To which other schools have you applied?*

Is there any additional information that the Admissions Committee should know about the applicant?*

Please upload any documentation necessary to expand upon the previous section.

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Parent/Legal Guardian 1:*

MotherFatherLegal Guardian

Name (Title, First, Middle, Last, Suffix)*

Street Address*

City*

State*

Zip*

Home Phone*

Mobile Phone*

Work Phone*

Home/personal email*

Work email

Employer*

Occupation*

Parent/Legal Guardian 2:

MotherFatherLegal Guardian

Name (Title, First, Middle, Last, Suffix)

Street Address

City

State

Zip

Home Phone

Mobile Phone

Work Phone

Home/personal email

Work email

Employer

Occupation

Parents' Marital Status (Check all that apply)*

If parents are separated/divorced, who has primary custody?

Parent 1Parent 2Joint Custody

If applicable, please include name(s) of step-parent(s):

Spouse/Partner of Parent 1

Spouse/Partner of Parent 2

Name

Age

School

Grade

Name

Age

School

Grade

Name

Age

School

Grade

Name

Age

School

Grade

Who is financially responsible for the applicant?*

Both ParentsMotherFatherOther

Would you like information regarding financial aid?*

YesNo

Would you like information regarding financial aid?*

YesNo

Name of person completing this application*

Relationship to the applicant*

Signature (parent or legal guardian)*

Clear

Date*

Enter Application Id Code

(if applicable)

Non-Refundable Application Fee*

Bridges Academy Application FeePrefer to pay by check? Please print and mail this form or the attached pdf to us at the address listed at the bottom of this form. Otherwise, please enter your payment information below.

$175.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Paying by check?

Please send the completed application form (a pdf version can be downloaded here), with the $175.00 non-refundable application fee payable to Bridges Academy, to:

Bridges Academy
ATTN: Admissions
3921 Laurel Canyon Blvd.
Studio City, CA 91604

818.506.1091
www.bridges.edu

NOTE: In addition to submitting this application form, please download the full application packet and return requested materials, save for the division-specific application forms included in the packet.

Applicant Basics*

APPLICATION FOR ADMISSION

APPLICANT INFORMATION

ADDITIONAL APPLICANT INFORMATION

FAMILY INFORMATION

Siblings

FINANCIAL RESPONSIBILITY