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First Name
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Last Name
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Date of Birth
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Nursery
Pre-Kindergarten
Kindergarten
1st Grade Eastern
1st Grade Western
2nd Grade Eastern
2nd Grade Western
3rd Grade Eastern
3rd Grade Western
4th Grade Eastern
4th Grade Western
5th Grade Eastern
5th Grade Western
6th Grade Eastern
6th Grade Western
7th Grade Eastern
7th Grade Western
Post-Graduate
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Mothers Name
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Address
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Home Phone
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Cell Phone #1
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Email Address #2
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Emergency Contact
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Allergies
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Tuition
Church Members: $400.00 per child.
Non-Members: $450.00 per child
School Opens September 16th at 9:30 am.
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