STUDENT INTEREST FORM
Ready to become a Breakthrough Scholar?

• Get a head-start on the school year.
• Join a group of kids as motivated as you are.
• Come to a place where its cool to be smart.
• Meet high school and college age role models.
• Reach for your wildest dreams.
• Be an inspiration to your community.

To register for an upcoming family information session and receive more information about our award-winning 8 year tuition-free academic enrichment program including 6-week Summer Institutes and Saturday School Year Program, complete the interest form below.

Please be sure to complete the form in its entirety. Submission of the form is considered an admission of demonstrated interest in our program. THE STUDENT INTEREST FORM IS NOT THE STUDENT APPLICATION. A link to the student application will be forwarded to you as soon as it becomes available.
 
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Student First Name *
Student Middle Name
Student Last Name *
Student Nickname (Optional)
Current Grade *
Scholar's Current School *
If "Other," what is the Scholar's current school?
Breakthrough Miami is looking for highly motivated students. As part of the admissions process we evaluate standardized test scores. Did your child score a 3, 4, or 5 on the FSA or the equivalent on a standardized test score? *
Breakthrough Miami is looking for highly motivated students. As part of the admissions process we evaluate academic grades for the current school year and the previous school year. Does your child have mostly As and Bs on their report card? *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Phone Number *
Type *
Parent/Guardian Email *
Confirm Email *
Address 1 *
Address 2 *
City *
State/Province *
Zip Code *
Site Preference *
How did you hear about us? *
If "Other," how did you hear about us?
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