Bright Beginnings Virtual Christian Academy (BBVCA) Enrollment Form
Student’s Name
First Name
Last Name
Student’s Date of Birth
-
Month
-
Day
Year
Date
Student’s Age
Gender
Male
Female
Parent’s Name
First Name
Last Name
Grade/Level
Relationship
(Father, Mother, Guardian, etc.)
Parent’s Email
example@example.com
Parent’s Phone Number
Format: (000) 000-0000.
Additional Parent’s Name
First Name
Last Name
Relationship
(Father, Mother, Guardian, etc.)
Parent’s Email
example@example.com
Parent’s Phone Number
Format: (000) 000-0000.
Student’s Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which track program would you like to enroll your child into?
Please Select
Track 1: Ages 3-5 from 3:00pm-3:45pm
Track 2: Ages 6-7 from 4:00pm-4:45pm
Track 3: Ages 5:00pm-5:45pm
Name of onsite parent/adult:
First Name
Last Name
Relationship
(Father, Mother, Guardian, etc.)
Student Hobbies & Interest:
Academic Strengths & Weakness (if applicable):
Upload headshot picture of student (Used for identification purposes only)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Virtual Equipment Checklist
Rows
Available
Not Available
Will Purchase
Desktop PC
Laptop
Tablet
Headset
Webcam
Acknowledgment
I acknowledge that my child will be participating in a virtual learning academy. I understand that I will read the portable student handbook in PDF format given by the school administrators and abide by it. I confirm that I will attend the online school orientation. I confirm that we (parents/guardians) will be responsible for providing the equipment needed for virtual or distance learning. I understand that if my child’s enrollment is accepted, I will be responsible for submitting the $50 non-refundable deposit within 1 business day to secure my child’s spot in the academy.
Date Signed
-
Month
-
Day
Year
Date
Parent Signature
Date Signed
-
Month
-
Day
Year
Date
Apply
Apply
Should be Empty: