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BMC Elementary Online Summer Program, June 15 - June 19, 2020, from 9 AM to 12 PM
The program is full. We are putting your child on the waiting list.
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Student's Last Name
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Your answer
Student's First Name
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Your answer
Grade Entering in Fall 2020
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2nd Grade
3rd Grade
4th Grade
5th Grade
Other:
Tell us why you would like to enroll your child into the program. Please describe your child’s background / classes and math achievements (if any) in the space below.
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Gender (For statistical purposes only)
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Male
Female
Other:
Parent 1 email
*
Your answer
Parent 2 email
Your answer
Parent 1 Name
*
Your answer
Parent 2 Name
Your answer
Parent 1 Phone
*
Your answer
Parent 2 Phone
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Student's Address (Street/City/State/Zip Code)
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School, Name, Address
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What kind of school do you go to?
Private
Public
Other
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What race/ethnicity do you most identify with?
African-American
Asian
Caucasian
Indian
Latino
Other:
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