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Enrollment Application
To apply for enrollment, please fill out the information below.
Student First Name
Student Last Name
Student Birthdate
Gender
Male
Female
Race
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Ethnicity
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Please List any additional students in your family seeking enrollment (include first name, last name, birthday, gender, grade entering, race and ethnicity)
Parent/Guardian First Name
Parent/Guardian Last Name
Relationship to student
Address
Email
Parent/Guardian Phone
Church
School coming from
Grade Entering
Choose an option
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Please describe any medical conditions your student has received treatment for or been diagosed with (i.e. heart trouble, asthma, seizures, diabetes, etc)
Food allergies? Please list all.
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