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Inquiry

ILS Inquiry

Thank you for your interest in our school!

Please fill out the form below and our Communications and Admissions Director, Deaconess Dorothy Glenn, will contact you and provide the information you desire.

* Indicates a required field.

Parent / Guardian Information
First Parent / Guardian Last Name * First Name * Salutation Email Address * Gender Male Female Cell Phone (Ex: 999-999-9999)	Second Parent / Guardian (leave blank if not applicable) Last Name * First Name * Salutation Email Address * Gender Male Female Cell Phone (Ex: 999-999-9999)

Home Address
Street Address City Country State Zip Home Phone (Ex: 999-999-9999) How Did You Hear About Us? Details: We are interested in the following start date for our child. Immediately January August Summer Camp Would like to discuss Student 1 First Name * Last Name * Birthdate (mm/dd/yyyy) Gender Male Female Grade Level of Interest * School Year * Current School Is There Another Student? Yes No Parent / Guardian Notes