Bizzell Application 2022-23
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Email *
Student Name (first and last) *
Primary Phone Number *
Other Phone
Date of Birth *
MM
/
DD
/
YYYY
Age *
Physical Address *
How do you get to school? *
Required
Current Number of Credits *
Current GPA *
What are your plans after college? *
Required
What career interests you? *
What is your favorite snack? *
STAAR EOC Tests
Please indicate your STAAR EOC results: *
Passed
Did Not Pass
Not Yet Taken
English I
English II
Biology
Algebra
US History
Bizzell Requirements and Expectations
The following are requirements to participate in the Bizzell Academy program. Checking the box indicates that you have read and understand the requirements.
Requirements *
Required
Agreement *
Required
College, Career, and Military Readiness Pathways
Please select at least two areas of interest: *
Required
Work Information
Are you currently employed? *
Acknowledgement 
If yes, where do you work?
Employer/Work Number:
Write your work schedule (days and times)
If you're not currently working, do you plan to obtain employment while enrolled in Bizzell Academy?
Clear selection
Family Information
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian Email *
Parent/Guardian Name #2
Parent/Guardian Phone Number #2
Parent/Guardian Email #2
School Information
Current Grade *
Number of Years in High School *
Have you ever, or are you currently, receiving Special Education or 504 services? *
Have you ever repeated a grade level? *
If yes, which grade(s)?
Do you have any children? *
Are you currently on parole, probation, deferred prosecution, or other conditional release? *
Have you ever dropped out of school? *
If yes, when did you drop out?
Program Questions
What is your toughest challenge in life right now? *
How do you manage it or what is your plan to overcome it? *
Why are you interested in attending Bizzell Academy? *
The majority of your work will be self-paced using the online Edgenuity program. How do you plan to stay on track to complete all your online courses? *
Reference Name (an adult who can recommend you as a good candidate for the program who is not in your family). A good candidate would be a high school counselor, recent teacher, or employer.  *
Reference Phone Number *
Further Information Needed!
Bizzell Academy will contact the following to ensure you have permission to attend:
-- Parent/Guardian
-- NHS Counselor/Principal 
We will need a copy of your current transcript if you are coming from a school outside of Navasota ISD. 
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