Lake Michigan Academy Student Information Form
Email address *
Student Information
Student's Last Name *
Student's First Name *
Student's Middle Name *
Student's Date of Birth
MM
/
DD
/
YYYY
Student's Cell Phone Number (If Applicable)
Student's Address
Street Address *
Apartment/Building/Suite #
City *
State *
Zip Code *
Please include the indicated information for my child in the LMA Student Directory.
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