BSE Foundations Application
Who is filling out the application?
*
Student
Parent/Guardian
Student + parent/guardian together
Which program date(s) are you able to attend?
*
5/30/2026, 12pm ET - 5:30pm ET (30 minute break 2:30pm - 3pm ET)
6/06/2026, 12pm ET - 5:30pm ET (30 minute break 2:30pm - 3pm ET)
Student Name
*
First Name
Last Name
Student Email
*
example@example.com
Student Phone Number
*
-
Area Code
Phone Number
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
-
Area Code
Phone Number
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Student Gender
*
Female
Male
Other
Student Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Grade Level (2025-26)
*
8th
9th
10th
11th
12th
Other
School Name
*
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In one-two sentences, describe what you would like to accomplish through BSE Foundations. If you aren't sure, let us know why you are interested in the program.
*
How did you hear about us?
*
Family member/friend
Facebook
Instagram
LinkedIn
Counselor referral
Name + email of who referred you
Do you have any additional questions for us?
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