BLE Academy Tutoring Registration
This form must be completed for each new student. After school programs and tutoring is available on a month to month basis. This means that you are not required to take the class/course for an entire school year. Please put N/A in any section that does not apply.
Email *
Child's Legal Name *
Child's Email Address *
CITY and STATE *
Child's Gender *
Parent/Guardian #1 Name *
Parent/Guardian #1 Email Address *
Parent/Guardian #1 Address (include city and state) *
Parent/Guardian #1 Phone Number *
Parent/Guardian #2 Name *
Parent/Guardian #2 Address (include city and state) *
Parent/Guardian #2 Phone Number *
Parent/Guardian #2 Email Address *
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