To register a new student at Immanuel, please contact the office at 575-622-2853 to schedule placement testing. This step is a prerequisite to enrolling. We will also require the student's SSN before enrollment is complete. This may be given in person at the office.

Last Grade Completed *

Marital Status of Student's Parents *

Students Lives With: *

Nature of Guardianship (grandparent, foster, etc.)

FATHER'S INFORMATION

Father/Guardian Name *

Father's Home Address

Name of Step-Parent (if applicable)

MOTHER'S INFORMATION

Mother/Guardian Name *

Mother's Home Address

Name of Step Parent (if it applies)

Is your family active in a church?

Yes

Name and Address of Your Church

Would you be interested in information about Immanuel Lutheran Church?

Yes

Is your student baptized?

Yes

If not, would you like information on baptism?

Yes

Most recent school and school's address: *

Most recent school's telephone number: *

Most recent teacher's name: *

What special honors or awards for scholastics or other achievements has your students received, if any?

Has this student attended ILS before? *

Yes

Has this student ever been refered for testing or placed in a special program? *

Yes

Has this student ever repeated a grade for any reason? *

Yes

If yes, please explain.

Has this student been involved in circumstances that led to an investigation by civil authorities? *

Yes

Has this student ever seen a counselor/doctor/psychiatrist for any type of social, behavioral, or mental problem? *

Yes

If yes, briefly describe the nature of the problem.

Has this student been tested or recommended for testing for any condition, which might affect school performance (i.e. ADD, ADHD, learning disabilities, behavior/emotional disorders, dyslexia)? *

Yes

What prompted your consideration of Immanuel Lutheran School? *

Did someone refer you to ILS?

Yes

If yes, please tell us who.

Other comments your student's teacher should know to help with your student's growth development?

EMERGENCY INFORMATION

Specific allergies and other conditions, if none please write NONE. *

Emergency Contact #1 *

Emergency Contact #1 Phone *

Emergency Contact #2 *

Emergency Contact #2 Phone *

IN CASE OF EMERGENCY: As the parent or legal guardian of the child named on this form, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.

Parent/Guardian Signature *

Clear

Immanuel Lutheran School is required by the State of NM to maintain complete immunization records for each enrolled student. All registrants must submit a copy of this information prior to attending.

The registration fee is $150.00 until June 1. After June 1, the registration fee is $200.00. The fee is required for a student to be officially registered and to secure their spot.

The registration fee must be included with this form to hold your student's place in school. *

K - 10th: $150

Who is financially responsible for tuition and fees? *

Tuition is due on the first of the month and is considered late if not paid by the 10th of the month. The signature below indicates that the parent/guardian agrees to abide by Immanuel Lutheran School's tuition policies.

Financial Responsible Person's Signature *

Clear

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

STUDENT INFORMATION

FAMILY INFORMATION

FATHER'S INFORMATION

MOTHER'S INFORMATION

CHURCH AFFILIATION

SCHOOL HISTORY

EMERGENCY INFORMATION

IMMUNIZATIONS

FEES