Immanuel Evangelical Lutheran School

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Immanuel Evangelical Lutheran School 1312 East 10th Street Alliance, NE 69301 (308)629-1601 [email protected]

….where a door to a Christian education opens for your child.

….where a door to a Christian education opens for your child.

To reserve a place for your child at our school for the 2017/18 school year, please return this application form along with the application fee to the school office at 1312 E 10th St or mail to PO Box 715, Alliance, NE 69301. Spaces will be filled as applications are received and paid with first consideration given to current students and members of the congregation. Formal registration information will be sent to the email address you provide below.

Today’s Date Student’s Name (First & Last) Student’s Birth Date Student’s Gender Student’s Current Address

2017/18 Grade Level (Check one)

Preschool: K 4

T/Th AM 1 5

M/W/F AM 2 6

M-Th PM 3 7

Mother’s Name Phone # Address (if different) Father’s Name Phone # Address (if different)

Parent’s e-mail address

Application Fees: Little Angels Preschool $50 paid cash /check rec or ck#_________ th Kindergarten - 7 grade $100 paid cash /check rec or ck#_________

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