Banning Lewis Ranch Academy at Northtree

Enrollment Updates

Apply Online

*= required field

*Student Last Name

*Student First Name

*Gender

	male
	female

*Birthdate

Ex mm/dd/yyyy

* Select School Year
(2012-2013 ONLY)

*Select Grade Level for year 2012-2013

Note: Students admitted to Kindergarten must be five years of age by October 1st of the school year applying for. 1st Graders must be 6 years old by October 1st.

*Present School Name

*Present School Address

*Current School District of Residence

Please indicate the district name/number and if you reside in Banning Lewis Ranch. Ex Falcon 49 BLR

*Parent/Guardian Last Name

*Parent/Guardian First Name

*Present Address

*City

*State

*Zip

*Home Phone

Example: (555-123-1234)

*Cell Phone

Example: (555-123-1234)

*Email Address

Is this child's sibling currently attending BLRA?

Yes No

If yes, siblings name(s) and grade

Is your child currently receiving Special Education Services?

Yes No

If YES, does your child currently have an IEP or 504 plan?

Yes No Not Applicable

What is her/her disability?

Enter the text shown in the box.

Security code is not case sensitive