Enrollment Form 2022-2023 Grades 1-8 International

ENROLLMENT FORM 2022-2023 GRADE 1-8 INTERNATIONAL
There is a $1000 application fee--please send this payment to the financial office in order for us to process your application. Please note that this payment is non-refundable. No student is allowed to attend classes if these fees are not paid in full.
Student Information
Student Name *

First Name Last Name
Grade in Fall 2022 *
Address *

Street Address

Apartment or Suite Number

City State / Province

Postal / Zip Code
Contact Email Address *
example@example.com
Parent / Guardian Information
Father's Name

First Name Last Name
Father's Phone Number
Mother's Name

First Name Last Name
Mother's Phone Number
Guardian's Name

First Name Last Name
Guardian's Phone Number
Parent Consent
Parent / Guardian Signature *

Clear
Printed Name *
Relationship to Child *
NON-DISCRIMINATION POLICY: Emmaus Lutheran School and Preschool admits students of any race, color or national origin or ethnic origin to all of the rights, privileges, programs and activities generally made available to students in the school. Emmaus Lutheran School and Preschool does not discriminate on the basis of race, color, or national origin or ethnic origin in administration of its policies, admissions policies, and scholarship/financial aid programs and athletic and other school administered programs.
Emmaus Lutheran School | 840 South Almansor Street, Alhambra, Ca. 91801 | 626-289-3664
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ENROLLMENT FORM 2022-2023 GRADE 1-8 INTERNATIONAL