BMC Elementary Application Fall 2018, New Students
Last Name *
Your answer
First Name *
Your answer
Grade Entering Fall 2018 *
Preferred time *
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. *
Your answer
Siblings in BMC Elementary in 2017 - 2018
Sibling in BMC Upper in 2017 - 2018
Have you ever taken "Math Kangaroo"? IF YES, what year?
Your answer
Gender (For statistical purposes only) *
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
Your answer
Out-of-State Emergency Contact *
Your answer
Does your child have serious medical conditions? If Yes, please specify in the next section *
If you answered "Yes" in the previous section, please list here any serious medical conditions of your child
Your answer
Student's Address (Street/City/State/Zip Code)
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School, Name, Address
Your answer
What kind of school do you go to?
Preferred Name
Your answer
What race/ethnicity do you most identify with?
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