Online Application for Enrollment

Student Information

First Name:    Middle Initial:    Last Name:

Street:    City:    Zip:

Home Phone:

Gender: Male Female

Date of Birth:    Place of Birth:

Student is applying for grade:

Church Membership

Church:    Pastor:

City:    ZIP:    Phone:

Student was baptized   dedicated on this date:

Home Information

Student is living with Parent(s)   Guardian(s)   Other:

Father's Name:    Occupation:

Place of Employment:    Work Phone:

Mother's Name:    Occupation:

Place of Employment:    Work Phone:

Cell Phone Number:    Whose cell # is this?:

E-mail Address:

Sibling's Name:    Age:    School:

Sibling's Name:    Age:    School:

Educational History

School Location Grades School Years

Policy of Non-Discrimination

Faith Lutheran School admits students of any race, color, sex, or national/ethnic origin to all the rights, privileges, programs and activities accorded or made available to students at the school. It does not discriminate on the basis of race, color, sex, and national/ethnic origin in administration of its educational policies and other school programs.