Illiana Pre-Registration 2019 form
Illiana (Current 5th - 7th graders) ~ June 16-21 ~ $269 ($50 deposit) ~ Full payment due by May 29
DEPOSIT/payment can be paid at the Church Office M-Th 8a-3p. Cash or Check
Name of Student 1 *
Your answer
Current Grade - Student 1 *
Name of Parents *
Your answer
Email Address (Parents) *
Your answer
Cell Phone (Parents) *
Your answer
Name of Student 2
Your answer
Current Grade - Student 2
Name of Student 3
Your answer
Current Grade - Student 3
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