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:
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.