Immanuel Lutheran Elmhurst New Early Childhood Student Application 
Please fill out the initial application for Immanuel's Early Childhood Programs. Additional information will be collected at a later time, but this Form, along with your registration fee, will secure your child's spot for the upcoming school year. 
A non-refundable registration fee is required to hold your child's spot. Pay here with a credit or debit card ($425 plus a processing fee) or bring a check for $425 to the school office, from 7:30 AM-5:30 PM. Your child's registration will not be added to our class counts until a credit card payment is made online or check has been received in our school office.
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Email *
Student's Last Name  *
Student's First Name *
Child's Date of Birth *
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DD
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Parent 1 Last Name *
Parent 1 First Name *
Parent 1 Primary Email
Parent 1 Primary Phone Number *
Age of child on September 1, 2024 *
Child's Ethnicity to be used for school recognition reporting
 *
What is your child's home church? (If applicable)
Please choose the class desired for 2024-2025. Those desiring part-time programs must choose the morning option they wish to enroll in. If part-time students will also be adding on afternoon programming, it should also be chosen here. 
Part-time options are listed below the full-time programs.
 *
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How are you paying the registration fee? *
Does your child have any allergies? Additional documentation will be required at a later date.  *
Does your child have any health concerns? Additional documentation will be required at a later date.  *
If you answered "yes" above  to either question, please explain.
Does your child have a 504, IEP, or did he/ she receive early intervention services? Further documentation may be required at a later date. *
Has your child reached developmental milestones as expected?
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If you answered "yes" above, please explain.
What month was your child baptized? (If applicable)
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Please read the statements below and check the appropriate response: *
Yes
No
I acknowledge that my child's spot is secured upon receipt of this Form and the registration fee.
I acknowledge that the registration fee is non-refundable.
I acknowledge that ILS has a two-month probationary period for all students during which it will be determined if your child's placement is best.
I acknowledge that additional tuition will be charged for the program.
I acknowledge that I will need to provide an original copy of my child's birth certificate for the office to copy before the school year begins.
I acknowledge that children enrolled in all early childhood programs must be potty trained, except for the Early 3's where Pull-Ups may be worn. Toilet trained means children can manage clothing, wiping, and washing hands.
I acknowledge that should we withdraw from ILS, the family must notify the school at least 30 days ahead of withdrawing. Tuition will be charged for that 30 days.
I want our family to be included in class lists visible to the ILS family through the school portal.
I want our email to be included in the school portal so other parents can connect with us.
I want our phone numbers to be included in the school portal so other parents can connect with us.
My child's tuition for 2024-2025  *
Thank you!
Thank you for the provided information! A member of our admissions team will be in contact soon.
A copy of your responses will be emailed to the address you provided.
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