Brilliant Star Application for Admission
School Year 2024 - 2025
Child's Name
First Name
Middle Name
Last Name
Age
Birth Date
Please select a month
January
February
March
April
May
June
July
August
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October
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December
Month
Please select a day
1
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Day
Please select a year
2025
2024
2023
2022
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2019
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1927
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1924
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1921
1920
Year
Gender
Please Select
Male
Female
N/A
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Number
Mother
Occupation/Company
Cell Number
Work Number
Email
Father
Occupation/Company
Cell Number
Work Number
Email
Program
Please Select
Toddler
Primary (3-5 yrs)
Lower/Upper Elementary
Select one
Length of day *(for Toddler and Primary)
Please Select
Half day 8:00 am -11:15 am
Full day 8:00 am - 3:00 pm
What are your child's interests?
Why are you considering enrolling your child at Brilliant Star?
How did you hear about our school?
Name and age of siblings
What languages are spoken at home?
What date would you like your child to start?
Does your child have any significant medical history?
Does your child have an educational or psychological diagnosis?
Does your child have previous school experience
Please Select
yes
no
Name of school
Length of attendance
Address and phone number
Any Educational Records (if applicable)
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DateTime
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Thank you for your interest in Brilliant Star!
An application fee of $50.00 can be paid at the main office. Please call 670-323-3827 or email principal@brilliantstar.org for any inquiries.
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