Mission Lutheran School - New Student Registration
Use this form to register your new child for Preschool - 5th grade. Upon completion, press SUBMIT. Stop by the school office to leave your $100 non-refundable down payment (applied towards the annual registration fee) New students also need to submit current vaccination records and records from the previous school (if applicable). Returning students do not need to resubmit this form, simply turn in your down payment. Registration information and enrollment agreements will be reviewed/signed later. Thank you!
Student First Name *
Student Last Name *
Student Birth Date *
MM
/
DD
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YYYY
Gender *
Registering for: *
Additional Registration/Fees notes:
New for 2020-21: Registration fee discounts are available. Reduced registration fees are charged when registration is paid in full by set dates. Ask in the office for specific details.

Also new for 2020-21: Students entering 4th & 5th grade will be charged a $150 annual technology fee.
Do you intend to make use of our After School Care program?
Clear selection
Contact Information
Home street address *
City *
State *
Zip code *
Mailing address if different than above
Mailing City
Mailing zip
Primary phone *
Father first name *
Father last name *
Father email
Father cell phone
Please include area code
Father employed by
Father work phone
Mother first name *
Mother last name *
Mother email
Mother cell phone
Please include area code
Mother employed by
Mother work phone
With whom does the student live? *
If "Other" checked above, please list who the student lives with.
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