Admissions Form

If you want to enroll at Lutheran High School, please complete and submit the followng form and you will be contacted about an interview appointment. A non-refundable registation fee of $250.00 is required to reserve a place if you are enrolling for the 2008-09 school year. Each additional child enrolling is $100.00.

 Student Last Name  

 First Name, Middle Initial  

Entering in 2008-2009 FreshmanSophomoreJuniorSenior

 Date of Birth 

 Place of Birth 

Social Security #

Current School 

Street Address

City

State

ZIP

Home Phone (XXX) XXX-XXXX

E-mail

Student Home: Student is living with ParentsMotherFatherOther

Mother's Name

Mother's Occupation

Mother's Place of Employment

Mother's Work Phone Number

Mother's Cell Number

Father's Name

Father's Occupation

Father's Place of Employment

Father's Work Phone Number

Father's Cell Number

Family Church Membership