Brilliant Star Application for Admission

Brilliant Star Application for Admission

School Year 2022-2023
Child's Name

First NameMiddle NameLast Name
Age
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Number

Area CodePhone Number
Mother
Occupation/Company
Cell Number

Area CodePhone Number
Work Number

Area CodePhone Number
Email
Father
Occupation/Company
Cell Number

Area CodePhone Number
Work Number

Area CodePhone Number
Email
Program
Select one
Length of day *(for Toddler and Primary)
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?
Start Date
Does your child have any significant medical history?
Does your child have an educational or psychological diagnosis?
Does your child have previous school experience
Name of school
Length of attendance
Address and phone number
Any Educational Records (if applicable)

Browse Files

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Signature

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