BTSB Inquiry Form 2025-2026 (English)

Required

Breakthrough Summerbridge Inquiry Form 2025 - 2026

Thank you for your interest in Breakthrough Summerbridge. Please fill out the form below.

Applications will be available in November 2025.

 

NOTE: Applicants must be in 6th grade during the 2025-2026 academic year to be considered for admission. 

Is your Breakthrough Summerbridge applicant currently in the 6th grade?requiredNote: Breakthrough Summerbridge only accepts applicants who are currently in the 6th grade.
Note: Breakthrough Summerbridge only accepts applicants who are currently in the 6th grade.
STUDENT INFORMATION
Preferred Pronounsrequired
How did you and/or your student hear about Breakthrough Summerbridge? requiredPlease select up to 1 choice
Please select up to 1 choice
Does your student have a device that has a camera? Check all that apply.requiredPlease select up to 4 choices
Please select up to 4 choices
If yes, does your student have a working camera attached to their device? required

School Information

Student Mailing Information

Parent/Guardian Information

Please include the contact information for the parent/guardian primarily responsible for the Breakthrough Summerbridge application process. 
XXX-XXX-XXXX
Do you (parent/guardian) speak a language at home other than English?* requiredPlease check all that apply.​​
Please check all that apply.​​
If yes, would you like language support in your native language?required
My student and I would like to attend the following in-person Breakthrough Summerbridge information session (at UHS campus).requiredPlease select up to 1 choice
Please select up to 1 choice