Academic Enrichment Program

Apply to Bright 'Lites Academy

You are one step closer to joining a learning community built on academic excellence, leadership development, and meaningful enrichment. Complete the application below to determine if BLA is the right fit for your family.

Before You Apply

Parent Info

Student Info

Academic & Behavioral

Tuition & Agreements

Parent / Guardian Information

Primary contact for this enrollment.

First Name *

Last Name *

Relationship to Student *

Email Address *

Phone Number *

Preferred Contact Method *

Home Address *

Authorized Pick-Up Person(s) *

Secondary Parent / Guardian Name

Secondary Parent / Guardian Contact

Student Information

Information about your child applying to the program.

Student First Name *

Student Last Name *

Preferred Name / Nickname

Date of Birth *

Month *

Day *

Year *

Current School Type *

Current School Name

Medical & Emergency Information

This information is kept confidential and used only to protect your child.

Emergency Contact Name *

Emergency Contact Phone *

Allergies

Medical Conditions

Is your child currently taking medication?

If yes, please describe the medication instructions.

Academic Information

Help us understand where your child is academically.

What are your child's greatest academic strengths? *

Has your child previously received tutoring or intervention services? *

What academic goals do you have for your child this year? *

Does your child currently have an IEP or 504 plan? *

Please provide more information about the IEP / 504 plan.

Social & Behavioral Development

This information helps us support your child from day one.

How would you describe your child's personality? *

Does your child struggle with focus, confidence, emotional regulation, or peer interaction?

Are there any behavioral concerns we should be aware of?

What social and emotional goals do you have for your child? *

Family Alignment

Help us understand your family's goals and expectations.

Why are you interested in Bright 'Lites Academy? *

What type of learning environment helps your child thrive? *

BLA House Preference

Which house best reflects your child's personality right now? Note: this does not guarantee placement into that specific house.

The Seekers — Seekers of Knowledge The Crowns — Leaders with Purpose The Pillars — Builders of Community The Flames — Carriers of Passion

Tuition Selection

Select the tuition tier you are applying for.

Standard Tuition — $1,872.94/month Accessible Tuition — $1,389.94/month (household income of $90,000 or below annually)

Agreements

Please review and confirm each of the following before submitting.

I understand the $100 application fee is non-refundable. I understand additional enrollment fees are due upon acceptance. I confirm that I have reviewed the Bright 'Lites Academy Parent Handbook. I understand that tuition payments, enrollment fees, and deposits are subject to the policies outlined in the handbook. I understand that failure to follow payment policies may result in withdrawal from the program. I understand that submitting this application does not guarantee acceptance. I agree to abide by Bright 'Lites Academy policies if accepted.

Electronic Signature

By typing your name, you acknowledge that you have reviewed and agree to all policies outlined by Bright 'Lites Academy.

Parent / Guardian Full Legal Name *

Date *

Your information is private. We will never share it.

Your child deserves an environment where they can grow academically, socially, and confidently.

✓

Your Application Is In

Thank you for applying to Bright 'Lites Academy. We are honored that you are considering BLA as part of your child’s learning journey. Your application has been received, and our enrollment team will review it with care. You can expect to hear from us within 5–7 business days.

We are excited to learn more about your family and the scholar you are raising. Questions? Contact us at 347-391-5163 or enrollment@brightlitesacademy.com.

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