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Thank you for your interest in Immanuel Christian School!

Please fill out the form below, and our Admissions Office will contact you shortly to provide additional information regarding your request.

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Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Gender *
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Gender *
  • Cell Phone *
Home Address
  • Street Address
  • City
  • Country
  • State
  • Zip
  • How Did You Hear About Us?
    Details:

  • Do you have any questions for us?
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  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •