Thank you for considering St. Paul’s Lutheran School for your child this/next year. Enclosed you will find an Application for Enrollment and a Tuition and Book Fee Schedule. An application needs to be filled out and returned for each child applying.
Complete all information on the application form, attach a copy of your child’s birth certificate, a copy of their last physical exam, including immunization record and a copy of their last report card and test scores, if available. Once you have completed the registration form, you may return it accompanied by a check in the amount of $50.00 (per application) to St. Paul’s Lutheran School Office.
Please note: If you have a child entering 2nd-8th grade, you will also find an Educational School Report enclosed. This form must be filled out by the school your child currently attends and returned with the application.
Once we have received your completed application, you will be contacted by the office for a meeting with the Principal, Mr. David Masengarb.
If you have any further questions, please contact the school office at 708-754-4492.
In Christ,
Shannon Porter
School Secretary
*If your child is in 2nd - 8th grade you will need to have an educational report filled out and turned in with your child's application. Click here for educational report.
DIRECTIONS FOR APPLICATION
1. Complete all information requested on the registration form. Please PRINT or TYPE.
2. A copy of the child’s birth certificate is required. Your child will not be allowed to start school without an official birth certificate in our records.
3. A physical examination by a licensed doctor is also required. (For Kindergarten and Grade 5 this must be done before the first day of August and turned in to the School Office.) A Sports Physical is required for Grades 6-8 for students intending to participate in sports activities. A DENTAL EXAM is due for all Kindergarten, Grade 2, and Grade 6 students.
4. Obtain a copy of the latest report card from the present school and attach to the registration form. (Grades 1-8 only).
5. Obtain a copy of the latest achievement test scores or Preschool readiness test results from their present school and attach to the registration form.
6. The Educational School Report must be completed by the school the student is presently enrolled in and attached to this application (Grades 2-8 only).
7. A $50.00 application fee per family must accompany this application when it is turned in to the office. (This applies to all first time families.)
COPY OF BIRTH CERTIFICATE (MANDATORY ALL GRADES)
COPY OF LATEST PHYSICAL EXAM, INCLUDING IMMUNIZATION RECORD
(MANDATORY ALL GRADES)
COPY OF LATEST REPORT CARD (GRADES 1-8)
COPY OF LATEST TEST SCORES
COPY OF COMPLETED EDUCATIONAL SCHOOL REPORT (GRADES 2-8)
St. Paul’s Lutheran School admits students of any race, color, national or ethnic origin to all their rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, admission policies, athletic programs and other school-administered programs.
APPLICATION FOR ENROLLMENT
St. Paul's Lutheran School, Chicago Heights, IL
Date of Application Application Fee Received
School Year Date Accepted
Proposed Grade Put on Waiting List
(To be completed by parent or guardian)
CHILD’S NAME
(Last) (First) (Middle)
STREET ADDRESS
CITY STATE ZIP
DATE OF BIRTH SEX TELEPHONE ( )
PLACE OF BIRTH
(City) (State)
DATE OF BAPTISM CHURCH
NAME OF CHURCH THAT CHILD ATTENDS
DOES YOUR CHLD ATTEND SUNDAY SCHOOL? REGULARLY?
Grades Repeated? Double Promoted?
Has your child been screened or tested for any special educational services?
Yes No
What were the recommendations of the screening or testing?
PRESENT SCHOOL:
What does your child like best about school?
What does your child dislike most about school?
LIST ANY OF YOUR CHILD’S PAST INTERESTS AND SUCCESSES; including academics, music, art or athletics:
FATHER: MOTHER:
Name (Last) (First) Name (Last) (Maiden) (First)
(Address – if different than child’s) (Address – if different from child’s)
(Occupation) (Occupation)
(Employer) (Phone) (Employer) (Phone)
(Last Grade Attended) (Last Grade Attended)
(Church Membership) (Church Membership)
Active Member? Active Member?
If you do not attend regularly now, would you consider attending St. Paul’s if your application is accepted? Yes No
If no, why not?
MARITAL STATUS:
Natural Parents Widowed Parent Never Married
Divorced Parents Separated Parent Divorced/Remarried
Child is living with: Mother Father Both
If remarried, spouse’s name
Is child adopted? Yes No Is child aware of adoption?
Other children in the family:
Name Date of Birth
Name Date of Birth
Name Date of Birth
Name Date of Birth
Other adults living in your home:
We (I) desire to learn more about the Lutheran Church
Who recommended St. Paul’s to you?
Why do you want your child to attend St. Paul’s?
AUTHORIZED TO PICK UP STUDENT IN CASE OF EMERGENCY:
NAME
TELEPHONE #
RELATIONSHIP TO CHILD
NAME
TELEPHONE #
RELATIONSHIP TO CHILD
These names and numbers will be kept on your child’s emergency card. Please update the school office as needed.
CHILD’S PHYSICIAN
PHYSICIAN’S ADDRESS
PHYSICIAN’S TELEPHONE
SPECIAL HEALTH CONCERNS AND/OR INSTRUCTIONS: