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(w/out payment link) 24-25 Enrollment Intake & Registration (Online)

Welcome to Burbrella Online Microschool!
Dear Families,
We are thrilled to welcome you and your learner to Burbrella Online Microschool, where each learner's journey towards academic excellence and personal growth is our top priority. As we embark on this exciting educational adventure together, we invite you to complete our enrollment and intake form now that your admission has been accepted.
This form serves as a comprehensive tool to gather essential information about your child, including their academic goals, learning needs, and any special requirements they may have. Your input will enable us to tailor our educational approach to meet the unique needs of your child, ensuring a fulfilling and enriching learning experience.
Additionally, this form includes details regarding registration fees. Please note that registration fees are included in the link provided and must be paid by June 30, 2024 for families who have accepted enrollment already. If you are registering after the June 1, 2024 date registration fees are due as soon as possible to ensure your learner has a spot.
Should you have any questions or require assistance with the enrollment process, please do not hesitate to reach out to us at . Our dedicated team is here to support you every step of the way.
Thank you for choosing Burbrella Microschool. We look forward to partnering with you in nurturing your child's academic and personal development.
Warm regards,
Burbrella Microschool Team
Learner Information
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Full Name

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DOB

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Select Learners Grade Level

Select...
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Select Learners Pod Level

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List Learners Hobbies/Interest

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Select Program Enrollment

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Learners Favorite Subject

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Families Academic Goals for Learner

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Families Social Emotional Goals

Educational Background (skip if re-enrollment)

Name of Previous School

Last Grade Completed

Date of Withdrawal and Withdrawal Reason

Does the learner have any Individualized Education Program (IEP) or 504 Plan? If yes, please provide details

Is there any other information about the student that would be helpful for us to know?

Please describe any accommodations or modifications that have been recommended for the learner as a result of their diagnosed learning disability (e.g., extended time for tests, preferential seating, access to assistive technology, etc.):

Parent Information:
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Parent Name:

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Parent Email:

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Parent Phone Number

Emergency Contact: (other than parent listed)
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Name

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Phone Number & Email


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Registration Agreement By signing below, you agree and understand that the registration fee is a one-time, non-refundable payment that ensures your learner has a reserved spot at Burbrella Microschool.

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