Bright Star Schools

BRIGHT STAR SCHOOLS STUDENT APPLICATION FORM

Mandatory fields marked *

Student Information

I am a: * New Student at Bright Star Returning Student at Bright Star
Student's First Name *
Middle Name
Last Name *
Gender * Male Female
Date of Birth *
Applying for Grade: *
Schools of Prior Attendance:
Elementary:
Middle:
High:

* If student has not yet attended Middle or High school please put the LAUSD home school for your address (if known).

Student's Home Address

House # * Street *APT #
City * Zip Code *
Home Phone *
Language *
Student Ethnicity

Parent Information

Mother's First Name Mother's Last Name
Mother's Cell Phone Mother's Email
Mother's Occupation Mother's Employer & Business Address
Mother's Work Phone

Father's First Name Father's Last Name
Father's Cell Phone Father's Email
Father's Occupation Father's Employer & Business Address
Father's Work Phone

Guardian or Additional Responsible Adult

First Name Last Name
Relationship to Student
Email Phone Number
Including the Child Applying, how many children live in the home?
Boys: Girls:
Please list, oldest to youngest:
First Name Last Name
Current Grade Current School

First Name Last Name
Current Grade Current School

First Name Last Name
Current Grade Current School

First Name Last Name
Current Grade Current School

Contact Information

I AUTHORIZE THE SCHOOL TO CONTACT, AND, IF NECESSARY, RELEASE MY CHILD TO ANY OF THE FOLLOWING INDIVIDUALS IN ADDITION TO THE PARENTS, SIGNIFICANT OTHER ADULT, and SIBLINGS LISTED ABOVE (must be over 21 years of age and have ID)

First Name Last Name
Relationship to Student
Phone #1 Phone #2

First Name Last Name
Relationship to Student
Phone #1 Phone #2

SIGNATURE OF PARENT or GUARDIAN COMPLETING THIS APPLICATION (Please print full name)
How did you hear about us?

OFFICE USE ONLY

Application Submitted - Date, Time, and Location
Staff: