Enrollment Form 24-25

Application for Student Enrollment 2024-2025

Thank you for taking the time to fill out an application to enroll your child at Zion-Concord Lutheran School. This form is for ALL students registering from Preschool 3 through 8th grade. Upon completion of this form, our principal, will be reaching out to you shortly to discuss the registration process with you.

A. Enrollment Information

Student First Name*

Student Last Name*

Preferred Name (The preferred name of Nicholas may be Nick)

Student Grade Level*

How many days a week will your child attend school?*

For your 3 Day a Week Enrollment Plan, which days of the week will your child attend school?*

Monday

Tuesday

Wednesday

Thursday

Friday

Days Summary:*

What length of day will your child attend?*

Please Indicate If Using Extended Care. Children that use Extended Care are required to sign the Extended Care Agreement Form*

Student Gender*

Student Birthdate*

/ /

Student 1 Baptismal Date (If the exact date is not known, please just give the month and/or year) *

Ethnicity (This is for reporting student data to the Illinois State Board of Education)*

Student Address*

Student City*

Student State*

Student Zip Code*

Has or does your child currently recieve any special services (Speech, OT, PT, etc), have a 504 plan, IEP, or ISP? *

Yes

Please Explain.*

Has your child reached developmental milestones at expected ages?*

Yes

Which milestones has your child reached differently?*

Please initial to indicate that the following statements are true about your child: Children must be completely toilet independent before attending school. Your child should be able to tell an adult when they need to use the toilet. He or she should be able to take care of their bathroom needs without assistance. They shoudl be able to clean themselves after going to the bathroom They should be able to get themselves dressed. PUll-ups and diapers are not permitted to be worn at school at any time.*

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Choose your signature image

Do you have any concerns about your child's development or skills?*

Yes

Please state your concerns.*

Has your child ever repeated a grade?*

Yes

Which grade was repeated and why?*

Is or has your child ever left the regular classroom for special assistance either part time or full time?*

Yes

Please explain.*

Did your child attend any previous schools before enrolling at Zion-Concord Lutheran School? If so please give the school(s) name, location, and the grades attended.*

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