BROOKLYN AMITY SCHOOL
Online Student Application Form
English | Espanol
 
  DEAR PARENTS AND APPLICANTS:
  Thank you for your interest in Brooklyn Amity School. Please fill out this application form completely. Falsifications, misrepresentations or omissions may disqualify your application.
   
   Applicant's Personal Information
   
      Year Applying: *
  Grade Applying: *
  Last Name: *
  First Name: *
Middle Name:
  Suffix:
  Date of Birth: *
  Gender: *
  State/City of Birth:
  Country of Birth:
  Resident Country:
Has applicant ever skipped a grade? * , If Yes Which Grade:
  Has applicant ever repeated a grade? * , If Yes Which Grade:
  Does the student have any learning disabilities? *
  if yes, Explain:
 
If Yes, does the applicant currently have an Individual Education Plan (IEP)?   *
  Please indicate any special health or educational needs of which we should be aware of and
which will help us plan and provide for the applicant's best possible educational experience:
  Please list applicant's honors, awards, or special achievements (in or out of school):
  Please list applicant's talents, interests, hobbies, club memberships, and activities:
 
 
Is the applicant currently under expulsion from any school or school district? *
  if yes, Explain:
 
   Applicant's School Information
   
  Current School: *
  School District: *
  School Address:
  School Phone:   XXX-XXXXXXX
  School Fax:   XXX-XXXXXXX
  Years Attended From:   *
 
   Applicant's Family Information
   
  Applicant lives with: * If Other  
         
  Primary Parent: * If Other: *
  Title:    
  First Name: * Last Name: *
  Street: *
  City: * State:      Zip:
  Home Phone: * Work Phone:
  Cell Phone: Email: *
         
  Secondary Parent: If Other :
  Title:    
  First Name: Last Name:
  Street:
  City: State:      Zip
  Home Phone: Work Phone:
  Cell Phone: Email:
         
         
   How did you hear about Brooklyn Amity School ?
   
   
       
           
  Please briefly state why you wish to have your child enrolled at Brooklyn Amity School.  
   
 
We hereby certify that, to the best of my/our knowledge and belief, the answers to the foregoing questions and statements made by me/us in this application are complete and accurate. I/We understand that any false information or misrepresentations of facts may result in rejection of this application or future dismissal of the applicant. We hereby certify that, to the best of my/our knowledge and belief, the answers to the foregoing questions and statements made by me/us in this application are complete and accurate. I/We understand that any false information or misrepresentations of facts may result in rejection of this application or future dismissal of the applicant.