Northern Lights Community School

Last Name (required)

(Please complete a separate application form for each student applying to NLCS)

First Name (required)

Middle Name (required)

Birthdate (Month/Day/Year) (required)

Street Address (required)

City/State/Zip Code (required)

Home Phone (required)

Email

Grade applying for

Select option

(Year) (required)

Select option

Student Status (required)

Select option

Is this student a child of a current NLCS Staff member?

Is this student a sibling of a currently enrolled student at NLCS?

How did you hear about us?

Parent/Guardian Information:

Mother / Father / Guardian (required)

Select option

Last Name (required) (Guardian 1)

First Name (required) (Guardian 1)

Middle Name (required) (Guardian 1)

Phone (required)

Email (Guardian 1)

Street Address (required) (Guardian 1)

City/State/Zip Code (required) (Guardian 1)

Mother / Father / Guardian (optional) optional

Select option

Last Name (optional) optional

First Name (optional) optional

Middle Name (optional) optional

Phone optional

Email (Guardian 2) optional

Street Address optional

City/State/Zip Code optional

Who does the student live with? optional

Parent/Guardian Electronic Signature (required)

Date (required)

Forms