BCA 2025-26 Family Contact Information

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Please complete the form below so we can ensure we have updated information for this school year. If anything changes over the course of the year, you can resubmit the form.

Student First Name (Primer Nombre de estudiante) *

Student Last Name (Appellido de estudiante) *

Date of Birth - Fecha de nacimiento *

YYYY

Parent/Guardian First Name - Primer Nombre de Padres/Guardian *

Parent/Guardian Last Name - Appellido de Padres/Guardian *

Relationship to Student (Relacion con estudiante) *

Preferred Language (Idioma preferido de communicacion) *

Parent/Guardian Home Phone (telefono de padre/guardian) *

Parent/Guardian Cell Phone (telefono celular de padre/guardian)

Parent/Guardian Email/Correo electronico de padres/guardian *

Address - Direccion

Apt/Numero de apartamento o casa

City/Ciudad *

State/Estado *

Zip Code/Codigo postal *

Please identify the student's current living arrangements. The answer you give will help determine what services you or your child may be eligible to receive under the McKinney-Vento Act. Please check one.

*Answers to this question will remain confidential. This information is being requested because the school has secured funds to support families in need.*

Doubled Up - With another family or other person because of loss of housing or as a result of economic hardship/Duplicado - Con otra familia u otra persona debido a la pérdida de vivienda o como resultado de dificultades económicas

Shelter - Emergency or transitional shelter/Refugio - Refugio de emergencia o de transición

Hotel/Motel - Living in what is NOT an emergency or transitional shelter and involves payment/Hotel/Motel: Vivir en lo que NO es un refugio de emergencia o de transición e implica un pago

Other Temporary Living Situation - Trailer park, campground, car, park, public places, abandoned building, street, or any other inadequate living space/Otra situación de vivienda temporal: parque de casas rodantes, camping, automóvil, parque, lugares públicos, edificios abandonados, calles o cualquier otro espacio habitable inadecuado.

Permanent Housing - Student who is living in a fixed, regular, and adequate housing situation/Vivienda permanente: estudiante que vive en una situación de vivienda fija, regular y adecuada.

Required

Emergency Contact #1 - Name/Contacto de emergencia n.° 1: nombre y apellido

Emergency Contact #1 - Relationship to Student/Relación con el estudiante

Emergency Contact #1 - Phone Number/Contacto de emergencia n.° 1: número de teléfono

Emergency Contact #1 - Email/Contacto de emergencia n.° 1: correo electrónico

Emergency Contact #2 - Name - Contacto de emergencia n.° 2: nombre y apellido

Emergency Contact #2 - Relationship to Student/Relación con el estudiante

Emergency Contact #2 - Phone Number/Contacto de emergencia n.° 2: número de teléfono/

Emergency Contact #2 - Email/Contacto de emergencia n.° 2: correo electrónico

Emergency Contact #3 - Name/Contacto de emergencia n.° 3: nombre y apellido

Emergency Contact #3 - Relationship to Student/Relación con el estudiante

Emergency Contact #3 - Phone Number/Contacto de emergencia n.° 3: número de teléfono/

Emergency Contact #3 - Email/Contacto de emergencia n.° 3: correo electrónico

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