Christ Lutheran Church and School
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Christ Lutheran Church and School
Application
A: STUDENT INFORMATION
Applying for Grade:
*
K
1
2
3
4
5
6
7
8
9
10
11
12
School Year
*
2021-22
2022-23
2023-24
2024-25
2025-26
Student Name
*
First Name
Last Name
Gender
*
Male
Female
Date of Birth
*
MM
DD
YYYY
Home Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
U.S. Citizen?
*
Yes
No
Name of Church
*
B: PARENTAL INFORMATION
Parents Are:
*
Married
Separated
Divorced
Never Married
Legal Guardian
One Deceased
Other
Please Specify if Other
Who is financially responsible?
*
Who is the legal guardian?
*
Parent/Guardian 1:
Prefix
*
Mr.
Mrs.
Ms.
Miss
First Name
Last Name
Mobile#
*
(###)
###
####
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Employer
Relationship to Student:
*
Parent/Guardian 2
Prefix
*
Mr.
Mrs.
Ms.
Miss
First Name
Last Name
Mobile#
*
(###)
###
####
Email
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Employer
Relationship to Student
*
Who may Christ Lutheran School correspond with?
*
Parent/Guardian 1
Parent/Guardian 2
Both
C: BACKGROUND INFORMATION
Learned about Christ Lutheran School from:
*
Website
Social Media
Word of Mouth
Other Advertising
Other
School my child most recently attended:
*
Name, City, State
Has your child ever skipped or repeated a grade?
If yes, please explain.
Does your child have a history of violent behavior in school?
If yes, please explain
Please list allergies, special medical or dietary needs, or other areas of concern.
Does your child have an IEP, 504 or service plan?
Is your child baptized?
*
Yes
No
D: FINANCIAL INFORMATION
Type of Scholarship
*
If Step Up For Students, please provide the Award Letter from Step Up For Students.
None
McKay
FES-UA
FES-EO
Step Up For Students
If McKay, what is the learning exceptionality that made your child McKay eligible?
If FES Unique Abilities, what is the learning exceptionality that made your child Gardiner eligible?
E: RELEASE AND STATEMENT OF COOPERATION
I/We the undersigned, agree that the information furnished on this Admission Application is true. I give Christ Lutheran School permission for my child to participate in all school activities, including but trips, car trips, sports activities, and school-sponsored off-campus field trips. I also give permission for my child's teacher or other agent of the school to make and enforce classroom regulations in a manner consistent with Christian principles and discipline as set forth in the Scriptures. Lastly, in the event that my child's picture appears in a photo or video, I give permission for release in any promotional communication.
*
Please type name as signature
Please type name as signature
Attend Church?
Yes
No
Read Bible as a Family?
Yes
No
Pray as a Family?
Yes
No
Talk About God at Home?
Yes
No
Watch Bible Content at Home?
Yes
No
Interested in Learning About Praying and Reading Bible?
Yes
No
Maybe
Interested in Learning About What Children are Learning about God and Bible?
Yes
No
Questions/Comments?
*
Thank you!