NBFA Lottery Application for K-6th Grades: 2026-2027 School Year (Bridgeport Residents Only)

Please complete the form below. Required fields marked with an asterisk *

Child's First Name*

Answer required for "Child's First Name"

Child's Middle Name

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Child's Last Name*

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Child's Date of Birth*

Answer required for "Child's Date of Birth"

Child's Gender

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Male

Female

Non-binary (students who do not identify exclusively as male or female)

Child's Ethnicity*

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Hispanic or Latino

Not Hispanic or Latino

Child's Race

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Black or African-American

American Indian or Alaska Native

Asian

Caucasian or White

Native Hawaiian or Other Pacific Islander

Two or more races, please list below:

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Which grade will your child enter for the 2026-2027 school year?

Answer required for "Which grade will your child enter for the 2026-2027 school year?"

Kindergarten (child must turn 5 on or before September 1)

First Grade (child should be 6 or 7 years old)

Second Grade (child should be 7 or 8 years old)

Third Grade (child should be 8 or 9 years old)

Fourth Grade (child should be 9 or 10 years old)

Fifth Grade (child should be 10 or 11 years old)

Sixth Grade (child should be 11 or 12 years old)

Does your child have any siblings already enrolled at NBFA?

Answer required for "Does your child have any siblings already enrolled at NBFA?"

Yes

If your child does have siblings at NBFA, please print the name and grade level (2026-2027 school year) of each sibling below:

Answer required for "If your child does have siblings at NBFA, please print the name and grade level (2026-2027 school year) of each sibling below:"

Please check all the areas in which your child has received services:

Answer required for "Please check all the areas in which your child has received services:"

Special Education (IEP Plan)

504 Plan

Speech & language

Social worker

Occupational Therapy

Physical Therapy

Birth-to-three

None

Please list the names of your child's previous schools. If your child has not attended a school or daycare previously then please indicate that below.

Answer required for "Please list the names of your child's previous schools. If your child has not attended a school or daycare previously then please indicate that below. "

Please check the following box to Release the Following information on my Son/Daughter

Answer required for " Please check the following box to Release the Following information on my Son/Daughter"

I HEREBY AUTHORIZE MY CHILD'S FORMER SCHOOL TO RELEASE RECORDS (academic, medical, IEP, 504, attendance, discipline) NEEDED

Please include your signature below to indicate your authorization of previous school records.*

Signature Required

Contact Information

Parent/Legal Guardian First & Last Name*

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Parent/Legal Guardian Email Address

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Parent/Legal Guardian Mobile Phone

Number Required

Parent/Legal Guardian Home Phone

Number Required

2nd Parent/Legal Guardian First & Last Name

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Parent/Legal Guardian Email 2

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2nd Parent/Legal Guardian Mobile Phone

Number Required

2nd Parent/Legal Guardian Home Phone

Number Required

Address

Student's Primary Address of Residence (house number and street):

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City

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Zip/Postal

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How did you hear about our school, New Beginnings Family Academy?

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Word of mouth

Social media

Community advertisement

Lawn sign

Referral

Other

Who referred you to NBFA?

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NBFA's Enrollment Policy

In accordance with NBFA’s enrollment policy, only students who reside in Bridgeport are eligible for enrollment. This residency requirement applies to all applicants, including siblings of current students.

Today's Date*

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Header Motto

Please fix the highlighted areas below before submitting.

NBFA Lottery Application for K-6th Grades: 2026-2027 School Year (Bridgeport Residents Only)