Navigate UP St. Johns Lutheran Day School Application Form
One application must be made for each child enrolled. Please complete, print
| Name of Person Enrolling Student(s) |
| Student's Legal Name: |
| Today's Date / / Students Gender: Male Female New Student Returning |
| Date of Birth: / / Place of Birth: |
| Grade Level in 2006-2007: New Student Returning |
| Present School: |
| School Address: |
| Present Church: |
| Church Address: |
| Student lives with (check all that apply): Please inform the school office if you require additional mailings. |
| Father Step-Father Mother Step-Mother Other (please name): |
| Names of parents or guardians with whom students lives |
| First: Last: Relationship: |
| Home Phone Work Phone Cell Phone |
| Mailing Address: |
| City: State: Zip code: |
| Occupation:Place of Business |
| Address: |
| City: State: Zip code |
| I give my permission to include our name, phone number, and address in the School Directory: Yes No |
| I am interested in volunteering at the school in the following way(s): |
| First: Last: Relationship: |
| Home Phone Work Phone Cell Phone |
| Mailing Address: |
| City: State: Zip code |
| Occupation: Place of Business |
| Address: |
| City: State: Zip code |
| I give my permission to include our name, phone number, and address in the School Directory: Yes No |
| I am interested in volunteering at the school in the following way(s): |
|
EMERGENCY INFORMATION |
| In addition to the parents and guardians previously listed, please provide the following information for persons who may be called in case of an emergency or to whom the student may be released should the school be unable to contact the parents. |
| Name of Family Doctor: Phone: |
| First Emergency Contact |
| First: Last: Relationship: |
| Home Phone: Work Phone Cell Phone |
| Mailing Address: |
| City: State: Zip code |
| Occupation: Place of Business: |
| Address: |
| City: State: Zip code |
| Second Emergency Contact |
| First: Last: Relationship: |
| Home PhHome Phone Work Phone Cell Phone |
| Mailing Address: |
| City: State: Zip code: |
| Occupation: Place of Business: |
| Address: |
| City: State: Zip code: |
|
THIS FORM MUST BE READ AND SIGNED BY BOTH PARENTS (OR GUARDIANS) |
| We understand and fully appreciate that the course of instruction offered by St. John's Lutheran School is very important to our child. In addition to the courses prescribed by the public school system, it also offers our child invaluable Christian training. In order to accomplish this, St. John's Lutheran School must have the cooperation of the home. We therefore pledge our full and active support to the Faculty and the Board of Day School Education in carrying out the Christian philosophy and objectives of St. John's Lutheran School and promise to do the following: |
| We pledge that we will set our child an example of Christian living by regular attendance at Church services, and by putting to practice what we learn and know to be the will of God. |
| We will accept the faculty of St. John’s Lutheran School as God's representatives while our child is at school, even as we are God's representatives to our child, and to support school discipline and to set our child a good example of respect for his teachers. |
| We agree to pay all fees and charges on time, meet our financial obligations to the church, and feel it our responsibility to attend P.T.L. meetings. |
| We hereby make application for the enrollment of our child in St. John's Lutheran School. |
| Parent's Signature: Date:// |
| Parent's Signature: Date:// |
Mail to: Saint John's Lutheran School - 527 Taylor Ave. Grand Haven, MI 49417