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Request Information

Thank you for your interest in Lakeland Christian School!

Please fill out the form below and our Admissions Office will contact you and provide the information you desire.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Gender
  • Work Phone
    (Ex: 999-999-9999)
  • Cell Phone
    (Ex: 999-999-9999)
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Gender
  • Work Phone
    (Ex: 999-999-9999)
  • Cell Phone
    (Ex: 999-999-9999)
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone *
    (Ex: 999-999-9999)
  • How Did You Hear About Us? *
    Details:
  • Do you know any LCS families?
    * Yes   No
  • If yes, please list who.
  • What church are you currently attending?
    *
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
    Email Address
    Gender
  • Grade Level of Interest *
    School Year *
  • Student Interests
    RISE COURSES
  • Current School
  • Does this child currently have an 504 plan or an IEP?
    * Yes   No
  • Is this child currently enrolled in special education classes?
    * Yes   No
  • Has this child ever been enrolled in special education classes in the past?
    * Yes   No
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •