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?

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student has an IEP?*

YesNo
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
Date of Registration

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

International Student Application Fee
$100.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

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

Student Information