Information Request Form Parent or Guardian full Name  * required Parent/Guardian daytime phone number  * required In what city and state do you reside?  * required   Parent email, to receive a response:  * required Student Name and Current Age:  * required Please select one, 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 type of curriculum emphasis are you interested? Christian Classical Education Customized Curriculum Accelerated Academics   In which types of enrichment education is your student interested? STEM (Science Tech, Enginering, Math) Arts and Crafts Leadership Development nature immersion, biology other, please describe in comment section   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 your learner attended:   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.