Bright School Application Form

Bright School Application Form
Student Information
Name of Applicant

First NameMiddle NameLast NameSuffix
Gender
Date of Birth

MonthDayYear
Date
Email
example@example.com
International Student?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student has an IEP?
Applying for Grade
School Last Attended
Parent(s)/Guardian(s) Information
Please list in order of whom to contact first
Health Insurance

Domestic students must complete this section. International student could skip.
Family Doctor

First NameLast Name
Clinic
Phone Number
Format: (000) 000-0000.
Date of Registration

MonthDayYear
Date
Application Fee
prevnext( X )
Application Fee
$50.00 Quantity

International Student Application Fee
$100.00 Quantity

Total

$0.00

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Student Information