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!
* Required
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Birth Date
*
MM
/
DD
/
YYYY
Gender
*
male
female
Registering for:
*
T/Th Preschool ($200 registration, $200monthly tuition / 9 months)
M/W/F Preschool ($280 registration, $280 monthly tuition / 9 months)
M-F Preschool ($380 registration, $380 monthly tuition / 9 months)
Kindergarten ($400 registration, $480 monthly tuition / 10 months)
1st Grade ($400 registration, $480 monthly tuition / 10 months)
2nd Grade ($400 registration, $480 monthly tuition / 10 months)
3rd Grade ($400 registration, $480 monthly tuition / paid 10 months)
4th Grade ($400 registration, $480 monthly tuition / 10 months)
5th Grade ($400 registration, $480 monthly tuition / 10 months)
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?
regularly
sometimes
never
Clear selection
Contact Information
Home street address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip code
*
Your answer
Mailing address if different than above
Your answer
Mailing City
Your answer
Mailing zip
Your answer
Primary phone
*
Your answer
Father first name
*
Your answer
Father last name
*
Your answer
Father email
Your answer
Father cell phone
Please include area code
Your answer
Father employed by
Your answer
Father work phone
Your answer
Mother first name
*
Your answer
Mother last name
*
Your answer
Mother email
Your answer
Mother cell phone
Please include area code
Your answer
Mother employed by
Your answer
Mother work phone
Your answer
With whom does the student live?
*
Both parents
Mother only
Father only
Other:
If "Other" checked above, please list who the student lives with.
Your answer
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