Friday, June 23, 2017

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Email Address*: Entering School Year*: Applying for Grade*:

Student's Name
First Name*: Middle Name: Last Name*: Gender*:
Address*: Birthdate*:
City*: State*: Zip Code*: Social Security Number:
Birthplace: Citizenship*: National Origin:
Parent Information: Does the applicant live with this parent or guardian?:
First Name*: MI: Last Name*: Relationship to Applicant*:
Address (If different than Applicant's):
City: State: Zip Code:
Home Phone: Work Phone: Cell Phone:
Occupation: Employer: City:
Parent Information: Does the applicant live with this parent or guardian?:
First Name*: MI: Last Name*: Relationship to Applicant*:
Address (If different than Applicant's)
City: State: Zip Code:
Home Phone: Work Phone: Cell Phone:
Occupation: Employer: City:
Which church does the applicant attend?: Church City: Pastor's Name: Applicant's Baptism Date*:
Current/Last School Name*: School City and State*: Current/Last Grade*:
Medical or Special Concerns or Restrictions*:
How did you hear about Our Savior Lutheran School?:
Hobbies, Talents, or Special Interests:
I / We agree to support Our Savior Lutheran School's teachers, administration, and policies and to pay our financial responsibilities as shown in the fees schedule and school handbook:
Father's/Guardian's Signature: Mother's/Guardian's Signature: Date:

* For Statistical Purposes Only. Our Savior Lutheran School does not discriminate on the basis of race, color, religion, or ethnic origin for admissions or programs.

After submitting this form, submit application fee, last 2 grade-level report cards, 2 teacher references, last 2 years’ standardized test results, and personal note for any special considerations.

© 2016 Our Savior Lutheran School.
98-1098 Moanalua Rd, ‘Aiea, Hawai‘i 96701
Tel: 808 488-0000 | Fax: 808 488-4515

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