TRINITY LUTHERAN SCHOOL-APPLICANT INFORMATION
The application fee is $50 if paid with cash, check, or money order.; or $52 if paid with credit card. You may call our school office, 808-621-6033, to pay with a credit card once you have submitted the application. Or you may mail payment (check or money order) to our school office. A copy of the applicant's birth certificate is required prior to enrollment. Complete all fields of this application form before clicking Submit. You are unable to modify the application form once submitted. If any areas are incomplete, a new application form will need to be completed.
Grade Applying For
School Year Applying For
Last Name
First Name
Middle Initial
Preferred Name
Current Grade
Date of Birth	JanFebMarAprMayJunJulAugSepOctNovDec010203040506070809101112131415161718192021222324252627282930312028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926
	Male
	Female
Birthplace (City, State)
Primary Address
Student's Baptismal Date	JanFebMarAprMayJunJulAugSepOctNovDec010203040506070809101112131415161718192021222324252627282930312028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926
Name & Location of Home Church
STUDENT LIVES WITH (select all that apply):
	Father
	Mother
	Step-father
	Step-mother
	Grandparent(s)
	Other (please explain)
STUDENT LIVES AT (select one):
	One Location
	Two Locations
	More Locations
ARE PARENTS DIVORCED?
	Yes
	No
HOW DID YOU HEAR ABOUT TRINITY LUTHERAN SCHOOL?
	Google Search
	Social Media
	Radio Ad
	Referral (Include name below)
Referred by:
	Other
If Other, please describe:
PLEASE LIST ALL SCHOOLS ATTENDED:
Grade Levels Attended; Name of School; Location
Grade Levels Attended; Name of School; Location
Grade Levels Attended; Name of School; Location
Grade Levels Attended; Name of School; Location
Grade Levels Attended; Name of School; Location
HAS THE APPLICANT SKIPPED A GRADE?
	Yes
	No
If yes, please explain & specify grade:
SUPPLEMENTARY STUDENT INFORMATION
PLEASE TELL US ABOUT YOUR REASONS FOR APPLYING TO TRINITY LUTHERAN SCHOOL?
IN WHAT WAYS DO YOU BELIEVE YOUR CHILD WILL CONTRIBUTE TO THE TRINITY LUTHERAN SCHOOL COMMUNITY?
HAS YOUR STUDENT EVER BEEN DIAGNOSED WITH ANY TYPE OF LEARNING DISABILITY?
	Yes
	No
If yes, please explain:
DOES YOUR STUDENT TAKE PRESCRIPTION MEDICATION FOR A LEARNING OR ATTENTIVENESS DIAGNOSIS?
	Yes
	No
If yes, please explain:
HAS YOUR STUDENT EVER BEEN DIAGNOSED WITH ANY TYPE OF SOCIAL, EMOTIONAL, OR BEHAVIOR CONDITION?
	Yes
	No
If yes, please explain:
HAS YOUR STUDENT EVER BEEN SUBJECT TO SERIOUS BEHAVIOR OR ACADEMIC DISCIPLINARY MEASURES, PLACED ON PROBATION, SUSPENDED, EXPELLED, OR ASKED TO WITHDRAW FROM ANY SCHOOL?
	Yes
	No
If yes, please explain:
WAS YOUR STUDENT EXCESSIVELY TARDY OR ABSENT FROM SCHOOL MORE THAN 10 DAYS DURING THE PAST SCHOOL YEAR?
	Yes
	No
If yes, please explain:
EXTRACURRICULAR & CO-CURRICULAR ACTIVITIES
Activity; Years; Accomplishments, Awards, Etc...
Activity; Years; Accomplishments, Awards, Etc...
Activity; Years; Accomplishments, Awards, Etc...
FAMILY INFORMATION
Father or Legal Guardian Name (Last, First):
Employer &/or Military Branch of Service:
Cell Phone:
Alternate Phone:
Home address (if different from child):
City
State & Zip Code:
Email address:
Mother or Legal Guardian Name (Last, First)
Employer &/or Military Branch of Service:
Cell Phone:
Alternate Phone:
Home address (if different from child):
City
State & Zip Code:
Email address:
#1 Sibling (Name, Age, Grade)
APPLYING TO TRINITY?
	Check here if YES
#2 Sibling (Name, Age, Grade)
APPLYING TO TRINITY?
	Check here if YES
#3 Sibling (Name, Age, Grade)
APPLYING TO TRINITY?
	Check here if YES
ADMISSION POLICY
Trinity Lutheran School admits students of any race, color, gender, nationality, and ethnic origin to activities generally accorded or made available to students at the school. We do not discriminate on the basis of race, color, gender, nationality, and ethnic origin in the administration of our educational policies, admission policies, scholarship programs, athletics, and other school-administered programs. Children with special needs are accepted on a non-discriminatory basis as long as our staff and our facility are able to meet their specific needs.
PARENTAL PLEDGE OF SUPPORT
We, the parents/guardians of this student applicant, pledge that we will give our full support to the administration, faculty, and staff of Trinity Lutheran School with regard to the mission, vision, and philosophy of the school, as well as with regard to the work and conduct required of our child. We further pledge that we will partner with Trinity Lutheran School in Christian education in our home through example by word and deed. We pledge that we will make tuition payments on time and promptly meet otther financial obligation as they arise, as well as give of our time and talent of the sake of contributing to the overall ministry of the school, including regular prayer.
Parent/Guardian Signature:
Date:	JanFebMarAprMayJunJulAugSepOctNovDec010203040506070809101112131415161718192021222324252627282930312028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926
Parent/Guardian Signature:
Date:	JanFebMarAprMayJunJulAugSepOctNovDec010203040506070809101112131415161718192021222324252627282930312028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926
Before submitting this form; please review to make sure all applicable fields have been answered. After clicking SUBMIT, the system does NOT provide confirmation that your form was successfully submitted. You will receive a confirmation email from the school office within one business day. Thank you!
Open House Participant Code:

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