Application Request Parent first and last Name  * required Parent phone number  * required City and State of Residence:  * required   Parent email, to receive a response:  * required Have you completed the 3 required enrollment steps? Yes, I have completed all 3 enrollment steps No, I have not completed all 3 enrollment steps Date you met with director and the director's  name:  * required In which enrollment activity did your student participate and on what date?  * required Student first Name and DOB:  * required Please select, which grade level is relevant for your learner? Junior Grade, ages 4-6 Upper Elementary, ages 7-10 Middle School, ages 11-13 High School, ages 14-18   In which program for gifted are you interested? Hybrid-Homeschool, 3 days a week Full time, M-F PSP, distance learning only   In which academic calendar are you interested? 6 months, April-September 2018 9 months, Sept-June 2018-19 12 months, including summer camps   Why are you interested in alternative, gifted education for your learner (primarily)? Has your learner ever attended a BLC program, workshop or shadow day? Yes No If yes, please tell us the name of the program and the date your learner attended:  * required   Do you have a question or a comment? Where did you hear of Baywood Learning Centers?  * required Please be ready to write down the information that will appear  in the next screen after you hit the submit button.

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