Breakthrough Miami Student Interest Form

Breakthrough Miami Student Interest Form - Summer 2026

To register for an upcoming family information session and receive more information about our award-winning 8 year tuition-free academic enrichment program including 6-week Summer Institutes and Saturday School Year Program, complete the interest form below.

Student First Name

Student Last Name

Student's Current Grade

What county does the student attend school?

Student's Current School

Student's current school

Student's Current School

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Phone Number

Type of Phone

Parent/Guardian Email

Address

City

State

Zip Code

How did you hear about us?