APPLICATIONS ACCEPTED MONDAY, JANUARY 30, 2017 - FRIDAY, APRIL 21, 2017
(please fill out a separate form for each child)
184 Garden Street Bridgeport, CT 06605 • T: (203) 384-2897 • F: (203) 384-2898 • www.nbfacademy.org
New Beginnings Family Academy provides students a meaningful, high-quality education through experience-based learningthat helps develop essential social, emotional and critical-thinking skills. This gives all children a foundation to achieve their full potential at every stage of life.
PLEASE ANSWER ALL QUESTIONS BELOW. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. PRINT CLEARLY.
- Grade Applying For:
- Child’s Name:First: MI: Last:
- Date of birth (mm/dd/yyyy):
- Does your child have any siblings already at NBFA? -Yes (Proceed to 6.) -No (Proceed to 7.)
- a. Sibling Name* Grade*
- b. Sibling Name* Grade
- Primary Language Spoken at Home: -English -Spanish -Other
- Please check all areas in which your child has received services: Pre-School
Speech and Language
Occupational or Physical Therapy
- Parent/Guardian Name:
- Home/Mailing Address: Street Address: City: State: Zip:
- Home Number: Work Number: Cell Number:
- Emergency Contact Name: Phone:
- How did you learn about NBFA?
New Beginnings Family Academy (NBFA) accepts applications for new students and blood siblings, or those with shared legal guardianship and living in the same home of existing students. NBFA does not discriminate on the basis of race, color, national origin, disability, sex, gender identity or religion. By signing below, you understand and agree to play an active role in your child’s/ren’s learning at home and school including, but not limited to, regularly attending school events and working collaboratively with administration and teachers. You understand and agree that a seat at NBFA is not guaranteed until an enrollment acceptance meeting is held with staff and the following documents are received: original birth certificate, Social Security card, current physical exam, up-to-date immunization and school records for transferring students. You understand and agree that failure to comply with any of the above will result in forfeiture of the seat.
I have read the above and, by signing below, I acknowledge that I agree to the terms outlined by New Beginnings Family Academy.
Parent/Guardian Signature Date(mm/dd/yyyy)
Office use only
Date received: Received by: