Date of Last Upload: Friday, January 17, 2020 Student Enrollment Form

   New Student Information
Select the Submit Application tab after you have filled in all information including students, primary and secondary family, and emergency/contacts. Use the tab buttons to select the pages to fill in the information. Required fields are bold.

Student 1

*Last Name*First Name*Middle Name*Preferred Name*Date of Birth (mm/dd/yyyy)SuffixTitle*Church Affiliation (or select "None")*Gender*Ethnicity*Personal E-Mail*Grade Level*Student Social Security Number*Student Resides WithOther children
Reason for applying to BCAPerson referring you to BCAHow did you hear about BCA
In the case of an accident, BCA is authorized to perform the following:Prescription medicine taking