Enrollment Application | St. Paul Lutheran Church & School

Thank you for choosing to apply to St. Paul Dorchester. Applications will be considered based on availability. A separate application must be submitted for EACH child that you are applying for. Upon acceptance, a $165 fee for the first child and $75 for each additional child, is due to the main office to enroll at St. Paul Lutheran School.

Student Information

Student(s) Name*

First Last

Student(s) Date of Birth*

Place of Birth*

Grade Entering*

Gender(s)*

Age(s)*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent Information

Parent Name (1)*

First Last

Parent Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Occupation*

Parent Name (2)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Occupation

Student Information

Does your child have any special needs or have an Individualized Education Plan (IEP) or 504 plan? If yes, please explain*

Does your child have any medical concerns? If yes, please explain.*

Does your child have any physical limitations? If yes, please explain.*

Has your child experienced any discipline/conduct problems? If yes, please explain.*

Who does the child spend most of the day with?

Please list all siblings and ages:

Former School Information

School Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Length of time enrolled?*

Last Grade Completed?*

Was the student promoted to the next grade level?

Did the student experience any difficulties at this school? If yes, please explain

What was the reason for transferring this student?

Did you leave this school with an unpaid balance? If yes, please explain.

How did you find out about St. Paul?*

Religious Affiliations

Student’s Baptism Date:

Family’s Church Membership:

Denomination:

Are you interested in visiting or joining St. Paul Church?

Are you interested in child or adult baptism?

Are you interested in Confirmation for 8th graders or adults?

Please note: New students are accepted on a probationary basis. Students’ academic achievement and behavior are closely monitored during the first quarter of the school year. I consent that all information that has been provided is true, correct, and complete. I understand that in order for my application to be complete, I must submit all school records, a copy of my child’s birth certificate, and any additional documentation the school requests.

Consent

Name

First Last

Date