Preschool & Kinderprep Application

Student Name

Gender

Address

Home Church

Baptism Date

Ethnic origin of child

Mother's Name

Mother's Address

Mother's Place of Employment

Mother's Cell Number

Mom's Email

Father's Name

Father's Address

Father's Place of Employment

Father's Cell Number

Father's Email

Marital Status

Legal Custody is with:

Child's resides with

Other children in the home

Does your child have an allergies?

Describe the allergic reaction

Do you consider your child to be:

What do you expect your child to gain from Mount Olive Lutheran Preschool?

Give any futher information which you believe will be helpful to us in understanding your child.

How did you become aware of Mount Olive Lutheran School?