K5 School Registration : St Mark Lutheran Church

Student's Name(Required)

First Last

Preferred Name

Student Type(Required)

New Student - Kindergarten

New Student - 1st - 3rd

Returning Student

What school will your student be transferring from?

Current Grade(Required)

Birthdate(Required)

Gender(Required)

Ethnicity(Required)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Other

Father's Name(Required)

First Last

Father's Primary Phone#(Required)

Father's Secondary Phone#

Father's Email(Required)

Father's Occupation

Father's Employer

Mother's Name(Required)

First Last

Mother's Primary Phone#(Required)

Mother's Secondary Phone#

Mother's Email(Required)

Mother's Occupation

Mother's Employer

Does the student live with Father and Mother at one residential address?(Required)

Yes

No

Student/Family Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Father's Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Mother's Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Do Father and Mother have joint custody of the student if they are not married?(Required)

Yes

No

Explanation of custody of student between parents.(Required)

Who will be financially responsible for the student's tuition?(Required)

Father & Mother

Father only

Mother only

Other

If "Other" will be financially responsible, please provide details below.(Required)

Has your child ever been evaluated for: learning differences, behavioral issues, hearing problems, psychiatric/psychosocial problems, visions problems or IQ?(Required)

Yes

No

Please provide a detailed description of the cause for evaluation, the evaluation itself, and resulting diagnosis and or treatments:(Required)

Have there been any situations in the child’s life which the school should know about in order to compassionately meet his or her learning or developmental needs (e.g. absence of parent, frequent moves, death in family, foster care, divorce, past abuse, etc.)?(Required)

Yes

No

Please provide a detailed description of the situations and consequent effect(s) your child:(Required)

Are you a member of St. Mark Lutheran Church?(Required)

Yes

No

I'm interested in membership

Are you a member of another Lutheran Church-Missouri Synod congregation?(Required)

Yes

No

Not sure

What LCMS congregation are you a member of?

What is your religious affiliation?(Required)

Where do you currently attend religious services?

Has your student been baptized?(Required)

Yes

No

At what congregation was your child baptized?

Name on Credit/Debit Card(Required)

First Last

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email receipt to:(Required)

Registration Fee(Required)

Price:

Credit/Debit Card(Required)

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2024-2025 School Registration

K5 Registration Form