BMC Elementary Application Fall 2017, New Students
Grade Entering Fall 2017
5 pm (All Grades)
6 pm (All Grades)
7 pm (Grades 3-4 only)
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.
Siblings in BMC Elementary in the Fall 2017
Grades 1- 2
Grades 3 - 4
Sibling in BMC Upper in the Fall 2017
Beginners Level I from 5:00 to 6:20 PM
Beginners Level II from 6:30 to 8:00 PM
Intermediate Level I from 6:10 to 7:55 PM
Intermediate Level II from 6:00 to 8:00 PM
Advanced from 6:00 to 8:00 PM
Have you ever taken "Math Kangaroo"? IF YES, what year?
Gender (For statistical purposes only)
Parent 1 email
Parent 2 email
Parent 1 Name
Parent 2 Name
Parent 1 Phone
Parent 2 Phone
Out-of-State Emergency Contact
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
Student's Address (Street/City/State/Zip Code)
School, Name, Address
What kind of school do you go to?
What race/ethnicity do you most identify with?
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