New Beginnings Family Academy

184 Garden Street, Bridgeport, CT 06605 - Phone: 203-384-2897 Fax: 203-384-2898
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	Fierce About Learning
	Admission Application and Reenrollment Form Forms are accepted between March 1 and April 15 ONLY. Forms received before March 1 or after April 15 will NOT be processed. At New Beginnings Family Academy, intelligence plus character is our ultimate goal. We prepare our students for outstanding academic success in high school, college and beyond by building intelligence plus character. NBFA accepts new applications for students up to 5th grade only. All current NBFA students must fill out a reenrollment form by the deadline to secure his/her seat for the upcoming school year. A separate application should be filled out for each child. Please complete the form below. Mandatory fields marked * Student Information My child is applying for :* Grade applying/reenrolling:* Child's First Name:* Child's Middle Name:* Child's Last Name:* Date of Birth (mm/dd/yyyy):* Gender:* Has your child ever received any special education services?* IF so, how many hours of service is your child receiving? Please check all areas in which your child has received services: Preschool Birth to Three Speech and Language Social Worker Occupational or Physical Therapy Does your child have siblings (brothers or sisters living in the same home) at NBFA?:* Please state sibling name(s): Race/Ethnicity: Black Hispanic White American Indian Asian American Primary Language Spoken at Home: English Spanish Other: Parent Information Parent/Guardian Name:* Home Mailing Address:* City:* State:* Zip Code:* Home Phone:* Work Phone: Cell Phone:* Email: Emergency Contact Name:* Signature I understand that parental participation and cooperation are required at New Beginnings Family Academy. As a parent/guardian, I agree to play an active role in my child's/children's learning at home and school including, but not limited to, fulfilling 20 service hours per academic year at New Beginnings Family Academy (10 additional for each sibling). I understand that space is limited in each grade and that siblings of current students are given preference. I understand that if my child/children is/are enrolled, I must attend a mandatory orientation session in order to secure his/her/their seat and I agree that failure to do so will result in a forfeiture of the seat. I understand that an original birth certificate, Social Security card, physical exam within the calendar year and up-to-date immunization record must be provided and I agree that failure to make these documents available will also result in forfeiture of the seat. Parent/Guardian Signature* Date:*
	© New Beginnings Family Academy. 184 Garden Street, Bridgeport, CT 06605 - Phone: 203-384-2897 Fax: 203-384-2898