Application 2021-2022 (English)
This is an application for potential seats for Kindergarten through 8th grade at BSNBCS.
 ***Students must be age 5 by December 31st, 2021 - students born before 2016 will not be accepted.

*To be included in the lottery your application must be submitted by April 1, 2021 by 4pm.
The Lottery will be held on April 8, 2021.

If you are having difficulty with the application - please call us, or come apply in person.

82 Lewis Ave, Brooklyn, NY 11206
p: (718) 453-1001. f: (718) 452-2090
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Email *
STUDENT INFORMATION
Student's First Name *
Student's Last Name *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Grade applying in 2021-2022 *
Current Grade *
Does the student applying have an IEP (Individual Education Plan?) *
Student Home Address (Street) *
Student apt # *
Student City *
Student State *
Student ZIP Code *
Current School Name (if applicable)
SIBLING INFORMATION
Does the student have a sibling already ATTENDING Bedford Stuyvesant New Beginning Charter School? *
If yes, what is the Sibling's name (or names)?
Does the student have a sibling APPLYING to Bedford Stuyvesant New Beginnings Charter School for another grade? *
If yes, what is the Sibling's name (or names)?
If yes, what is the Grade that the sibling is applying to?
PARENT/GUARDIAN INFORMATION
Name of Parent/Guardian *
Relationship to Student *
Cell Phone *
Home Telephone
Work Telephone
Email *
Home Address (street) *
Apt #
City
State
Zip Code
Name of 2nd Contact Person *
Relationship of 2nd Contact Person to Student *
2nd Contact Cell Phone Number *
2nd Contact Home Phone Number
2nd Contact Email
OTHER INFORMATION AND ATTESTATIONS
How did you find out about BSNBCS? *
What is your Community School District (CSD)?
Affirmation Statement
Bedford Stuyvesant New Beginnings Charter School will not discriminate against any student, employee, or other person on the basis of national origin, ethnicity, gender, or disability or any other grounds that would be unlawful if done by any other public school.

*BSNBCS has lottery preferences for children of staff, siblings of current students, students with IEP's and for students in our district.

I understand that to be eligible for admission preferences, I must submit proper documentation. Failure to do so will result in my application being ineligible for these preferences.


Parent signature (type your name below if you agree) *
A copy of your responses will be emailed to the address you provided.
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