Saint Luke Academy Application 2021/22

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Parent (1) Name* This field is required.

First Name

Last Name

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Parent (1) Phone* This field is required.

Area Code

Phone Number

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Parent (1) Email* This field is required.

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Parent (1) occupation:

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Student lives with

Parent (1) primary custody

Parent (2) primary custody

Both Parents

Guardian

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Address (primary residence of student)

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Parent (2) Name

First Name

Last Name

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Parent (2) Phone

Area Code

Phone Number

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Parent (2) Email

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Parent (2) occupation:

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Name of Student (1)* This field is required.

First Name

Last Name

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Student (1) Birth Date* This field is required.

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Student (1) Gender

Male

Female

Would rather not say

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Has Student (1) attended school before?

YESNO

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List name of school and reason for transfer.

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What grade will Student (1) enter in September 2021?* This field is required.Select from dropdown:

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For preschool students, are you interested in full- or part-time?

Full-Time

Part-Time

Unsure at this time

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Add another child?* This field is required.

No

Yes

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Name of Student (2)* This field is required.

First Name

Last Name

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Student (2) Birth Date* This field is required.

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Student (2) Gender

Male

Female

Would rather not say

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Has Student (2) attended school before?

YESNO

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List name of school and reason for transfer.

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What grade will Student (2) enter in September 2021?* This field is required.Select from dropdown:

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For preschool students, are you interested in full- or part-time?

Full-Time

Part-Time

Unsure at this time

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If you wish to enroll more than two students, please complete this application for the first two and complete an additional application as necessary.

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Saint Luke Academy is proud of its racial, ethnic, and economic diversity. Students come from a wide variety of backgrounds and are taught to respect other traditions as they enjoy their own. This demographic information is sometimes necessary for grants and funding.

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Please select one:* This field is required.

Hispanic/Latino

White, Non-Hispanic

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Saint Luke Academy is a diverse and inclusive environment that accepts students from many different Christian and non-Christian denominations and supports students' participation in the worship life of their home congregations.

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Family is a member at (church name):

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Student (1) was baptized at Church Name on Date .

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Student (2) was baptized at Church Name on Date .

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Would you like to pay $100 application fee by check, cash, or credit card?* This field is required.

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PAYING BY CHECK

Your application will not be considered final until Saint Luke Academy has received your (non-refundable) application fee.

Please mail check (payable to Saint Luke Academy) to:

Saint Luke Academy

1500 W. Belmont Ave

Chicago, IL 60657

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PAYING BY CASH

Your application will not be considered final until Saint Luke Academy has received your (non-refundable) application fee. If you prefer to pay with cash, please stop by the school office at the main 1500 W. Belmont Church Office/School Office entrance.

For mutual convenience, please contact the school office at 773-472-3837 to arrange the best time to stop by.

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PAYING BY CREDIT CARD

Please provide all of the information below.

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Non-Refundable Application Fee

My Bag

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Application Fee
$100.00+
Back

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

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Do you have any additional comments you would like included in your application?

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