February 22, 2012
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The Bridge School
Accredited Online Education for Grades 7-12
Contact An Academic Advisor
Phone: 713-493-2600
Email:
advisor@thebridgeschool.net
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Enroll – Schools Only
Student
Legal Name
*
Prefix
First
Last
Suffix
SSN
*
Format as 123-45-6789
Date Of Birth
*
MM
DD
YYYY
Gender
*
Male
Female
Ethnicity
Hispanic or Latino or Spanish Origin of any race
American Indian or Alaskan Native
Asian
Native Hawaiian or Other Pacific Islander
Black or African American
White
Two or more races
Race and Ethnicity unknown
--
Address
*
Street Address
Address Line 2
City
State / Province / Region
Zip / Postal Code
Home Phone
*
Provide cell here if no home phone.
Cell Phone
Email
*
Contact #1
Name
*
Prefix
First
Last
Suffix
Address Same As Student
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Home Phone
*
Work Phone
Cell Phone
Email
Relationship To Student
*
Mother
Father
Other
Relationship
Employer
Occupation
Preferred Language
Contact #2
Name
Prefix
First
Last
Suffix
Address Same As Student
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Home Phone
Work Phone
Cell Phone
Email
Relationship To Student
Father
Mother
Other
Relationship
Employer
Occupation
Preferred Language
Emergency Contact/Contact #3
Name
*
Prefix
First
Last
Suffix
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Home Phone
*
Work Phone
Cell Phone
Email
Relationship To Student
*
Employer
Occupation
Preferred Language
School Information
If you don't have any of the information requested in this section, please respond NOT SURE and our Academic Advisors will work with you once the application is processed to gather the remaining information. All information will be required for enrollment to be complete and verified.
Previous Schools
*
Please list all schools attended since entering 9th grade, starting with the most recent school attended. List the name of the school, the school district and the school phone number and mailing address.
Have you ever attended The Bridge School?
*
Yes
No
Did you obtain any high school credit while in middle school?
*
Yes
No
Name of Middle School
Current Grade Level
*
6th
7th
8th
9th
10th
11th
12th
Course(s) interested in taking (please list one course per line):
Why are you taking classes?
*
Course not offered on my campus.
Credit recovery.
Getting ahead.
Catching up.
Other.
Reason
School Counselor
*
First
Last
Phone
*
Email
*
Where do you want records sent if not graduating from The Bridge School?
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
School Phone
School Fax
School Counselor
If discharged from The Bridge School, where would you like your grades sent?
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
School Phone
School Fax
School Counselor
Payment
Please enter number with no symbols (ex: 100.00)
Payment Amount
*
The Bridge School Offers
Individual guidance from Academic Advisors
International accreditation by SACS CASI
Approved by the Texas Education Agency
Earn an accredited high school diploma
Flexible/Open Enrollment - start any day
Up to 6 months to complete a course
Easily transfer credits to and from your current school
Course credit by exam
Regular progress reports made available to students and parents
Contact Us
Name
Email
*
Phone
Message
*
How Did You Hear About Us?
Brochure/Flyer
Counselor/Teacher
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