2018-19 Enrollment Application
The online enrollment application must be completed to generate your tuition worksheet and registration packet. Registration is considered complete upon receipt of registration fees.
$100 registration fee per family. $50 early registration fee discount if paid April 7.
Last Name of Student *
Your answer
First Name of Student *
Your answer
Middle Name of Student *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender of Student *
Required
Student first language spoken at home *
Required
Religion *
Required
Student resides with *
Required
Enrolling Grade for 2018-2019
Student resides in the following school district *
If student resides outside Lawrence County, please list county of residence and public school corporation below.
Your answer
Race/Ethnicity *
Home Phone # for Student or guardian cell if no home phone *
Your answer
Last Name of Guardian 1 *
Your answer
First Name of Guardian 1 *
Your answer
Guardian 1 relationship to student *
Guardian 1 Street or Co Rd Address *
Your answer
Guardian 1 City *
Your answer
Guardian 1 Zip Code *
Your answer
Guardian 1 Email Address *
Your answer
Guardian 1 Preferred Phone # including area code *
Your answer
May we text you at this number? *
Guardian 1 Place of Employment (if no place of employment enter NA) *
Your answer
Guardian 1 Work Phone # including area code (if no place of employment enter NA) *
Your answer
Last Name of Guardian 2 (NA if no 2nd guardian)
Your answer
First Name of Guardian 2
Your answer
Guardian 2 relationship to student
Guardian 2 Email Address
Your answer
Guardian 2 Street or Co Rd Address if different than Guardian 1
Your answer
Guardian 2 City if different than Guardian 1
Your answer
Guardian 2 Zip Code if different than Guardian 1
Your answer
Guardian 2 Preferred Phone # including area code
Your answer
May we text you at this number?
Guardian 2 Place of Employment (if no employment enter NA)
Your answer
Guardian 2 Work Phone including area code (if no employment enter NA)
Your answer
Emergency Contact Name if parents cannot be reached *
Your answer
Emergency Contact Phone Number *
Your answer
Do you have another child to enroll? *
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