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Immanuel Lutheran School Enrollment
Enroll at Immanuel Lutheran in grades Pre-Kindergarten 3 & 4.
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Email
*
Your email
Student's Last Name
*
Your answer
Student's First Name & Middle Initial
*
Your answer
Student's Address
*
Your answer
Student's Birthdate
*
Your answer
1st Child's Grade
*
Your answer
1st Child's Gender
*
Male
Female
Is Your 1st Child Baptized
*
Yes
No
2nd Child's Last Name
Your answer
2nd Child's First Name & Middle Initial
Your answer
2nd Child's Birthdate
Your answer
2nd Child's Grade
Your answer
2nd Child's Gender
Male
Female
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Is Your 2nd Child Baptized
Yes
No
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3rd Child's Last Name
Your answer
3rd Child's First Name & Middle Initial
Your answer
3rd Child's Birthdate
Your answer
3rd Child's Grade
Your answer
3rd Child's Gender
Male
Female
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Is Your 3rd Child Baptized
Yes
No
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Phone Number
*
Your answer
Church Membership
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Your answer
Emergency Contact 1
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Your answer
Emergency Contact 2
Your answer
Physician Contact Info
Your answer
One Call Contact Info (Label as Mom's Cell etc.)
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General Permissions (Please check all that apply)
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Gym Class
Field Trips
Photo/Video Release
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