Application Form

Valley Lutheran High School

Application for Admission (New Students)
Student Information
Things you will need:
1. Student Information
2. Parent/Guardian Information
3. Student Essay Responses
Student's Name*

First NameLast Name
Student's Nick Name or Alternative Name (when applicable)

First NameLast Name
Applying for Grade*
Academic Year*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
Gender*
Student Cell*
Student Email*
example@example.com

Church Information
Home Church
Denomination
If you are a member of an association church, we will contact your Pastor to confirm your active congregational membership, making your student eligible for a tuition discount.
Pastor Signature

Does your child have documented special learning needs?*
Has your child been involved with any significant school discipline (suspension, expulsion, etc.) within the last two years?*
How did you hear about Valley Lutheran High School?*
Friend, Church, Child's Grade School

Student Essay

Student, please answer the following questions, each in less than 200 words.
Why do you want to be educated in this type of academic and spiritual setting?*

0/200
What goals do you have for the school year (educational, spiritual, social, etc.)?*

0/200

Valley Lutheran High School is a Christian educational community centered on God and his redemptive action through His Son, Jesus Christ. We are called into a personal relationship with him, which in turn, is lived out in relationships with each other. You are asked as a student and parent/guardian to be in a community commited to God, prayer, worship and a lifestyle that reflects a holy, loving God. With these thoughts in mind, please sign below and submit this application to Valley Lutheran High School.
Parent/ Guardian Signature*
Type full name of Parent/Guardian for signature*
Type full name of Student for signature*
Date*

MonthDayYear
Date
Student Signature*
Date*

MonthDayYear
Date

Fee must be paid in order to complete and submit application.*

Application Fee$75.00

Enter coupon

Total $0.00

Valley Lutheran High School