2017-2018 PRESCHOOL and PREKINDERGARTEN APPLICATION
2017-2018 PRESCHOOL and PREKINDERGARTEN APPLICATION
FAMILY INFORMATION Student’s Name ___________________________________________________________________M ____F ____ (Last) (First) (Middle) Date of Birth _______________Where? ____________________ Ethnicity _________Home language___________ Church Membership of Student ___________________________________________________________________ Date of Student’s Baptism ______________________ Where? __________________________________________ Parent/Guardian #1 (where student resides): Marital Status of Parents ______________________ Last Name _____________________________________ First Name _____________________________________ Address ____________________________________________________________________________________ (Street & Number) (City) (State) (Zip) Home Phone _____________________ Cell Phone ____________________ Work Phone ____________________ Place of Work ___________________________ E-Mail _______________________________________________ Church Membership ______________________________________________________ Is it LCMS? ____________ May we include the following in our FastDirect Buzz Book? Home and/or cell number: Yes ____ No ____, Address: Yes ____ No ____, E-mail address: Yes ____ No ____ Parent/Guardian #2 Last Name ____________________________________ First Name ______________________________________ Home Phone _____________________ Cell Phone ____________________ Work Phone ____________________ Place of Work ___________________________ E-Mail _______________________________________________ Church Membership ______________________________________________________ Is it LCMS? ____________ Address _____________________________________________________________________________________ (Only if different from Parent/Guardian #1) May we include the following in our FastDirect Buzz Book? Home and/or cell number: Yes ____ No ____, Address: Yes ____ No ____, E-mail address: Yes ____ No ____
SCHOOL INFORMATION
School district in which child lives _________________________________________________________________ Name of assigned public school __________________________________________________________________ Previous school(s) child attended _________________________________________________________________ Grade last completed ___________ Any special education requirements? __________________________
HEALTH INFORMATION Does your child have any allergies? ______ Does your child require medication during school hours? __________ Does your child have any medical conditions? _____ Is your child unable to participate in physical activities? _______ Has your child been diagnosed or tested for developmental delays? __________ If you answered yes to any of the above questions, please explain: _______________________________________ _____________________________________________________________________________________________
OTHER INFORMATION Where did you hear about us? Did anyone refer you? _________________________________________________ Please explain any special circumstances that we should be aware of (educational needs, divorce, etc.) _____________________________________________________________________________________________ _____________________________________________________________________________________________ List names and ages of other children in family (give birthdates) _________________________________________
PRESCHOOL SESSION DESIRED (check one box) DISCLAIMER: You’re signing up for a class, not a particular teacher. Availability of a particular class is subject to meeting minimum enrollment numbers.
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3-yr-old Tuesday/Thursday mornings 3-yr-old Monday/Wednesday/Friday mornings 3-yr-old Monday through Friday mornings 4-yr-old Tuesday/Thursday mornings 4-yr-old Monday/Wednesday/Friday mornings 4-yr-old Monday through Friday mornings Prekindergarten Monday-Friday mornings
9:00am – 11:30am 9:00am – 11:30am 9:00am – 11:30am 9:00am – 11:30am 9:00am – 11:30am 9:00am – 11:30am 8:45am – 11:45am
$1200 annually $1500 annually $2000 annually $1200 annually $1500 annually $2000 annually $2300 annually
Prekindergarten students must be 4 by June 1 or receive principal approval. Prekindergarten students may be evaluated for their readiness before their admission is official.
Tuition may be paid annually by August 15 for a 3% discount rounded to the nearest dollar or in ten equal installments beginning August 1. Please submit application with $150 non-refundable registration fee to: Shepherd of the Lakes Lutheran School 2101 S. Hacker Rd. Brighton, MI 48114 Make checks payable to: Shepherd of the Lakes (SOTL) For office use only Date received______ Registration fee paid? _____ Check Number _____ Principal approval of placement ______
FAMILY INFORMATION Student’s Name ___________________________________________________________________M ____F ____ (Last) (First) (Middle) Date of Birth _______________Where? ____________________ Ethnicity _________Home language___________ Church Membership of Student ___________________________________________________________________ Date of Student’s Baptism ______________________ Where? __________________________________________ Parent/Guardian #1 (where student resides): Marital Status of Parents ______________________ Last Name _____________________________________ First Name _____________________________________ Address ____________________________________________________________________________________ (Street & Number) (City) (State) (Zip) Home Phone _____________________ Cell Phone ____________________ Work Phone ____________________ Place of Work ___________________________ E-Mail _______________________________________________ Church Membership ______________________________________________________ Is it LCMS? ____________ May we include the following in our FastDirect Buzz Book? Home and/or cell number: Yes ____ No ____, Address: Yes ____ No ____, E-mail address: Yes ____ No ____ Parent/Guardian #2 Last Name ____________________________________ First Name ______________________________________ Home Phone _____________________ Cell Phone ____________________ Work Phone ____________________ Place of Work ___________________________ E-Mail _______________________________________________ Church Membership ______________________________________________________ Is it LCMS? ____________ Address _____________________________________________________________________________________ (Only if different from Parent/Guardian #1) May we include the following in our FastDirect Buzz Book? Home and/or cell number: Yes ____ No ____, Address: Yes ____ No ____, E-mail address: Yes ____ No ____
SCHOOL INFORMATION
School district in which child lives _________________________________________________________________ Name of assigned public school __________________________________________________________________ Previous school(s) child attended _________________________________________________________________ Grade last completed ___________ Any special education requirements? __________________________
HEALTH INFORMATION Does your child have any allergies? ______ Does your child require medication during school hours? __________ Does your child have any medical conditions? _____ Is your child unable to participate in physical activities? _______ Has your child been diagnosed or tested for developmental delays? __________ If you answered yes to any of the above questions, please explain: _______________________________________ _____________________________________________________________________________________________
OTHER INFORMATION Where did you hear about us? Did anyone refer you? _________________________________________________ Please explain any special circumstances that we should be aware of (educational needs, divorce, etc.) _____________________________________________________________________________________________ _____________________________________________________________________________________________ List names and ages of other children in family (give birthdates) _________________________________________
PRESCHOOL SESSION DESIRED (check one box) DISCLAIMER: You’re signing up for a class, not a particular teacher. Availability of a particular class is subject to meeting minimum enrollment numbers.
p p p p p p p
3-yr-old Tuesday/Thursday mornings 3-yr-old Monday/Wednesday/Friday mornings 3-yr-old Monday through Friday mornings 4-yr-old Tuesday/Thursday mornings 4-yr-old Monday/Wednesday/Friday mornings 4-yr-old Monday through Friday mornings Prekindergarten Monday-Friday mornings
9:00am – 11:30am 9:00am – 11:30am 9:00am – 11:30am 9:00am – 11:30am 9:00am – 11:30am 9:00am – 11:30am 8:45am – 11:45am
$1200 annually $1500 annually $2000 annually $1200 annually $1500 annually $2000 annually $2300 annually
Prekindergarten students must be 4 by June 1 or receive principal approval. Prekindergarten students may be evaluated for their readiness before their admission is official.
Tuition may be paid annually by August 15 for a 3% discount rounded to the nearest dollar or in ten equal installments beginning August 1. Please submit application with $150 non-refundable registration fee to: Shepherd of the Lakes Lutheran School 2101 S. Hacker Rd. Brighton, MI 48114 Make checks payable to: Shepherd of the Lakes (SOTL) For office use only Date received______ Registration fee paid? _____ Check Number _____ Principal approval of placement ______
