Brooklyn Academy HS - New Student Intake

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Email *

Student Name *

Date of Birth *

YYYY

Student OSIS Number *

Guardian Name/Relationship *

Home Phone *

Mobile Phone *

Student Email Address *

Street Address *

Apartment *

Borough *

Zip Code *

what year did student begin 9th grade *

Previous High Schools attended *

Number of credits *

Regents passed

Yes

ELA

Algebra

Global History

US History

Living Environment

Geometry

Earth Sci

Check all that apply *

I have an IEP

I receive English language Learner support (ELL)

I have a section 504 for health accommodations

None of the above

Required

Primary Home Language *

Does the student have a health condition? Please list all *

Have You been suspended? Please list the reason(s) why. *

Does the student have any children? *

If so, are you interested in the on-site LYFE program for childcare? *

Who referred you to Brooklyn Academy High School? *

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