Admissions Application | Northbridge AZ College Success Program

Student's Info

Name *

First

Last

Email *

What is your race/ethnicity? *

Phone *

Are you currently in high school? *

Yes
No

Okay! Have you received a high school degree or equivalent? *

Yes
No

What high school did you attend?

About You

Answer these questions to the best of your ability, it helps us get to know you better! 2-4 sentences is sufficient – don't feel like you have to share your whole story.

What inspired you to apply for NorthBridge? *

Give a summary of any learning differences, troubled areas, or challenges that the student has or suspect they have. *

What are your career or post-secondary goals?

Academic Info

What school or institution are you attending/planning to attend? *

Are you registered with Disability Resource Services (DRS) on campus? *

Yes
No

Have you submitted a FAFSA yet? *

Yes
No

Are you receiving financial assistance from any of the following?

Grants
Student Loans
Scholarships
Other

Availability

Let us know your availability to attend NorthBridge sessions, so that we can pair you with an academic coach that's right for you!

How would would your student prefer to meet?

In-Person
Virtual
Hybrid

Documents

Please upload a PDF copy of your college transcripts, IEP/504 Plan, Transition Plan, and most current testing.

Click or drag files to this area to upload. You can upload up to 10 files.

Upload a copy of your class schedule (PDF or screenshot is acceptable!)

Click or drag files to this area to upload. You can upload up to 10 files.

Payment

Admission Fee *

Price: $50.00

I understand that I must pay a $50.00 nonrefundable fee to begin the initial Application process with NorthBridge College Success Program

Terms & Conditions *

I agree to the terms & conditions below.

I understand that I must pay a $50.00 nonrefundable fee to begin the initial Application process at NorthBridge. This fee does not guarantee admittance into NorthBridge, but does ensure consideration for enrollment by the Admissions Committee. NorthBridge is a 501(c)(3) not-for-profit organization that seeks and accepts students for admission without discrimination against any person because of race, color, religion, national origin, disability, or gender. The Admissions Committee adheres to these guidelines when determining a student’s eligibility and appropriateness for placement in the NorthBridge program.

Do You Have a Discount Code?

Your Price

Price: $50.00

The discount code you entered is not valid. No discount has been applied.

Payment Info *

Card

Name on Card

How did you hear about us? *