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Inquiry

Immanuel Lutheran School Inquiry

Thank you for your interest in Immanuel Lutheran School!

Please fill out the form below and our Secretary, Ksenia Mirly will contact you and provide the information requested.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone *
Home Address
  • Street Address
  • City
  • Country
  • State
  • Zip
  • Home Phone
  • How Did You Hear About Us? *
    Details:

  • We are interested in the following start date for our child.
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Current School *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •