The Bilgrav School Admissions Application

Parent Information
Parent/Guardian 1 Name*

First NameLast Name
Parent/Guardian 1 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 1 Phone Number*

Area CodePhone Number
Parent/Guardian 1 Email*
example@example.com
Parent/Guardian 1 Profession*
Parent/Guardian 2 Name*

First NameLast Name
Parent/Guardian 2 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 2 Phone Number*

Area CodePhone Number
Parent/Guardian 2 Email*
example@example.com
Parent/Guardian 2 Profession*
Parents are:*

MarriedSeparatedDivorcedNever married
If divorced, and Parent 1 is remarried: (Type N/A if not applicable)*
Name of Step-Parent
If divorced, and Parent 2 is remarried: (Type N/A if not applicable)*
Name of Step-Parent
Please, list the names and ages of other children in the family.*

Parent Questionnaire
What educational support is your child currently receiving (i.e. tutoring, speech and language support, etc.)?*
Please inform us regarding the sequence of your child’s education. Has your child ever:*

Repeated a gradeSkipped a gradeMissed school for an extended periodBeen asked to withdraw from a schoolBeen suspended or put on probationNoneOther
If yes to any of the above, please comment below if you wish.
At present, is your child taking any prescription medications?*

YesNo
If so, kindly list them. (Type N/A if not applicable)*
Has your child displayed behavioral problems in school or at home?*
Does your child have a history of emotional problems or psychological counseling?*
The information provided herein is the sole property of The Bilgrav School and is accurate and contains all information requested. We have neither omitted nor embellished any facts relating to our child’s application. The Bilgrav School reserves the right to amend or withdraw offers of admission due to mitigating circumstances, changes in information, student’s standing or other reason as determined by the Admissions Committee.

RECORDS RELEASE
CONFIDENTIAL
I am the parent/guardian of a child applying for admission to The Bilgrav School. I request that all pertinent information concerning my child’s medical, psychological, and academic history be forwarded to The Bilgrav School Admission Office. These records include, but are not limited to, academic records, medical records, psychological evaluations, speech and language evaluations, and neuropsychological evaluations. I give permission for The Bilgrav School to contact all service providers for any additional information.
Type a question

I give my consent.I do not give my consent.
This release shall remain effective from the date above until such time as I revoke consent in writing or my child’s enrollment at The Bilgrav School ceases.

Tuition Agreement
Please, indicate how you intend to pay.*

I intend to pay tuition privatelyI intend to use a McKay scholarship from the State of Florida, and will pay the difference privately.I intend to use a scholarship from the State of Florida other than the McKay, and will pay the difference privately.I intend to use a non-State scholarship, and will pay any difference privately.I intend to seek funding from our school district, but will pay privately if funding is not approved.Other
If applicable, in addition to parent/guardian, please send financial correspondence to:
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Should be Empty:

Admissions- Application