Home Address (number, street, apt, city, state, zip) *
Your answer
Student email address (must be an account you monitor regularly; communication about the lottery will be sent through this email address; preferably your BISD email if you are a BISD student) *
Your answer
Student telephone number *
Your answer
Are you currently a BISD student? *
If so, what is your BISD ID number? *
Your answer
What middle school do you attend? *
What is the primary language spoken at home? *
Your answer
Are you receiving free or reduced lunch? *
Do you have internet access at home? *
Parent/Guardian 1 - Name (Last, First) *
Your answer
Relationship to student *
Highest level of Parent/Guardian 1's education *
Parent/Guardian 1 - phone number *
Your answer
Parent/Guardian 1 - email *
Your answer
Parent/Guardian 2 - Name (Last, First)
Your answer
Relationship to student *
Parent/Guardian 2's address if different from Parent/Guardian 1.
Your answer
Highest level of Parent/Guardian 2's education
Clear selection
Parent/Guardian 2 - phone number
Your answer
Parent/Guardian 2 - email
Your answer
A copy of your responses will be emailed to the address you provided.