Online Pre-registration
Your Name*
Your email*
Primary Phone Number*
Alternative Phone Number
Full Name of Student*
Address*
City*
Zip Code*
Current School (if applicable)
Grade (If enrolling for the next school year, please select the grade the student will be entering.)*
Student's Sex*
 Male
 Female
Student's Birthdate*
Please fill out the following fields if you have more than one child you would like to enroll at Peace Lutheran School.
Full Name of Second Student
Grade (If enrolling for the next school year, please select the grade the student will be entering.)*
Student's Sex
 Male
 Female
Student's Birthdate
Full Name of Third Student
Grade (If enrolling for the next school year, please select the grade the student will be entering.)*
Student's Sex
 Male
 Female
Student's Birthdate
Additional Children (please enter name, grade, sex, and birthdate):
Name of Parent/Legal Guardian*
Parent/Legal Guardian's Place of Employment*
Name of Other Parent/Legal Guardian*
Other Parent/Legal Guardian's Place of Employment*
Other Parent/Legal Guardian's Cell Phone
Special Medical/Educational Considerations:
Currently Participating in State Scholarship Programs*
 Step Up for Students
 John McKay Scholarship
 Gardiner (PLSA) Scholarship
 N/A
Additional Comments or Questions
E-Signature of Parent or Legal Guardian (enter your full name):*
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Submit
Jesus said, "Let the little children come to me and do not hinder them, for to such belongs the kingdom of heaven." ~ Matthew 19:14

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