Bridges Accelerated Learning Center Application 2019-2020
Student Last Name *
Student First Name *
Date of Birth *
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Age *
Home Campus *
Grade *
Student cell phone number *
Student Email *
Parent name *
Parent cell phone number *
Parent Email *
Parent/Guardian Name
Parent/Guardian Cell Number
Parent Email
Are you currently or have you taken classes through Edgenuity? *
Do you qualify for any of the below programs? *
Required
List any medications you take regularly. *
Medically diagnosed health conditions (Ex. pregnancy, asthma, diabetes, etc.) *
How badly do you need Bridges? *
It would be nice but I don't have to accelerate my learning
I won't graduate if I don't get to come to Bridges
What are you plans after high school? *
Share two things that make school hard for you. *
Share two ways we can best help you achieve your goals. *
List 3 teachers we should ask to complete a recommendation form. *
Parent Consent *
Required
Submit
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