BeeSchool Application

*First Name

Middle Name

*Last Name

Nickname

*Date of Birth (MM/DD/YYYY)

*Gender

*Street Address

*City

*State

*Zip Code

*Phone

*Email Address

*Country of Citizenship

*First Name

*Last Name

Address is same as applicant

Home Address (if different from Applicant)

City

State

Zip Code

*Personal Email

*Phone

*Title/Profession

Employer

First Name

Last Name

Address is same as applicant

Home Address (if different from applicant)

City

State

Zip Code

Personal Email

Phone

Title/Profession

Employer

Current School

Applicant is Not Currently Enrolled in School

School district where you currently reside

How did you hear about Upland?

Ex: website, word of mouth, family, advertisement,

Names and Birthdays

Has the applicant ever had a serious injury or disability?

Yes

No

Is your child potty trained?

Yes

No

Work in Progress

Initials

Are you interested in applying for Financial Aid?

Yes

No

What is your annual combined household income?

*Person(s) Responsible for All Tuition and Fees

*Parent/Guardian 1

Parent/Guardian 2

*Date