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BVLA TRANSFER REQUEST FORM
This form is for current BPS families seeking transfers into the Brockton Virtual Learning Academy (Grades 6-12) for the 2025-2026 academic year.
STUDENT'S NAME
*
First Name
Last Name
STUDENT'S DATE OF BIRTH
*
-
Month
-
Day
Year
Date
STUDENT ID NUMBER
CURRENT SCHOOL
*
Please Select
ANGELO SCHOOL
ARNONE SCHOOL
ASHFIELD MIDDLE SCHOOL
BAKER SCHOOL
BROCKTON HIGH SCHOOL
BROCKTON THERAPEUTIC DAY SCHOOL
BROCKTON VIRTUAL LEARNING ACADEMY
BROOKFIELD SCHOOL
DAVIS K-8 SCHOOL
DOWNEY SCHOOL
CHAMPION HIGH SCHOOL
EAST MIDDLE SCHOOL
GEORGE GLOBAL STUDIES SCHOOL
GILMORE SCHOOL
HANCOCK SCHOOL
KENNEDY SCHOOL
NORTH MIDDLE SCHOOL
RE-ENGAGEMENT CENTER
PLOUFFE MIDDLE SCHOOL
PROMISE COLLEGE & CAREER ACADEMY
RAYMOND SCHOOL
SOUTH MIDDLE SCHOOL
WEST MIDDLE SHCOOL
GRADE in 25-26
*
Please Select
7
8
9
10
11
12
DESIRED SCHOOL CHOICE
*
Please Select
BROCKTON VIRTUAL LEARNING ACADEMY
BASED ON SEAT AVAILABILITY
Will an adult be home to supervise the student while attending BVLA?
Yes
No
REASON FOR TRANSFER
*
TRANSPORTATION IS NOT A VALID REASON FOR A TRANSFER REQUEST.
PARENT/GUARDIAN NAME
*
First Name
Last Name
PARENT/GUARDIAN EMAIL
example@example.com
PARENT/GUARDIAN PHONE
*
Please enter a valid phone number.
ADDRESS
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PARENT/GUARDIAN SIGNATURE
*
UPLOAD PARENT/GUARDIAN PHOTO ID
*
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