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Applicant First Name
*
Applicant Last Name
*
Contact Email
*
Phone Number (ex. 954-123-3456)
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Date of Birth - Applicant
*
+
Grade level applying for - Applicant
*
PK-3
PK-4
K
1
2
3
4
5
Does the applicant have a diagnosed learning difference? (Yes or No) If yes, please send 504/ IEP / psycho-educational evaluation to admissions@nbps.org.
*
Yes
No
Are you applying for the Lighthouse Point Academy (LPA)? This program is for students with diagnosed mild learning differences. (Yes or No) If yes, please send 504/IEP/psycho-educational evaluation to admissions@nbps.org.
*
Yes
No
Ethnicity
Asian
Black/African
Caucasian
Hispanic/Latino
Native American
Pacific Islander
Mixed Race
Other
Prefer not to answer
Expected Starting Date
*
2023-2024 (8/21/2023- first day of school)
2023-2024 (after first day of school)
Not Sure
What extracurricular activities are you interested in?
*
How did you hear about us?
Is there anything else you would like to tell us about your child's interests?