Apply to Banning Lewis Ranch Academy for
2008-2009 School Year Enrollment
We will contact you if/when a seat becomes available for your child.
*
= required field
*
Student's Last Name
*
Student's First Name
*
Gender
male
female
*
Birthdate
* Select School Year applying for (2008-2009 ONLY)
Select Year Applying For
2008-2009
Note: BLRA does not carry future waitlists from year to year.
*
Select Grade Level for year applying for
(select)
kindergarten
first grade
second grade
third grade
fourth grade
fifth grade
sixth grade
seventh grade
eighth grade
Students admitted to Kindergarten must be five years of age by October 1st
of the school year applying for.
*
Present School Name & School District
Present School Address
*
Parent/Guardian Last Name
*
Parent/Guardian First Name
*
Current School District of Residence
*
Home Street Address
enter the child's home address
*
City
*
State
(select)
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
*
Zip
*
Home Phone
enter home phone number, area code first
*
Work or Cell Phone
enter a work/cell phone number where you may be reached during the daytime
Best Time to Call
Email Address
Does this child have a sibling currently enrolled?
Yes
No
If yes, child's name
Is your child currently receiving Special Education Services?
Yes
No
If YES, does your child currently have an IEP?
Yes
No
Not Applicable
What is her/her disability?
Enter the text shown in the box.
