Student/Family Information

First Name

Last Name

Grade student will be entering at BIA

9th 10th 11th 12th

Student's Preferred First Name/Nickname

Sex

Male Female

Date of Birth

Birthplace (City, State/Province, Country)

Country of Citizenship

First Language

Second Language (if applicable)

Language spoken in the home

Parent/Guardian Mailing Name (eg., Mr. & Mrs. John Doe)

Home Street Address

Home Street Address 2

City

State

Zip or Mailing/Postal Code

Country (if not in the US)

Phone Number (Home or best contact number)

Primary Parent/Guardian Email

During his/her time at BIA, please indicate where your student will be staying

----------------Current School----------------------

Student's Current School

City, State/Province, Country of current school

Date student began attendance at current school

Date student finished/will finish attendance at current school

Highest grade will complete at current school

----------------Previous High Schools(Transfer Students Only)----------------------

Previous high school attended (if applicable)

City, State/Province, Country of previous high school

Date student began attendance at previous high school

Date student finished/will finish attendance at previous high school

If student attended another high school as well, please list the name of this previous high school

City, State/Province, Country of previous high school 2

Date student began attendance at previous high school 2

Date student finished/will finish attendance at previous high school 2

----------------Family situation----------------------

Student lives with

Parent status

Please note the person financially responsible for the student

----------------Parent/Guardian Information----------------------

Relationship with Parent/Guardian 1

Parent/Guardian 1 First Name

Parent/Guardian 1 Last Name

Parent/Guardian 1 Suffix

Same Address

Parent/Guardian 1 Street Address

Parent/Guardian 1 Street Address 2

Parent/Guardian 1 City

Parent/Guardian 1 State

Parent/Guardian 1 Zip or Mailing/Postal Code

Parent/Guardian 1 Country (if not in the US)

Parent/Guardian 1 Phone Number (Home or best contact number)

Parent/Guardian 1 Email

Parent/Guardian 1 Employer

Parent/Guardian 1 Job Title

Relationship with Parent/Guardian 2

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Suffix

Same Address

Parent/Guardian 2 Street Address

Parent/Guardian 2 Street Address 2

Parent/Guardian 2 City

Parent/Guardian 2 State

Parent/Guardian 2 Zip or Mailing/Postal Code

Parent/Guardian 2 Country (if not in the US)

Parent/Guardian 2 Phone Number (Home or best contact number)

Parent/Guardian 2 Email

Parent/Guardian 2 Employer

Parent/Guardian 2 Job Title

----------------Sibling Information----------------------

Names and Ages of Siblings

----------------Current School----------------------

----------------Previous High Schools(Transfer Students Only)----------------------

----------------Family situation----------------------

----------------Parent/Guardian Information----------------------

----------------Sibling Information----------------------

about

contact