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Request Information

Thank you for your interest in Lutheran East!

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 *
  • Last Name *
  • Email Address *
  • Gender
  • Cell Phone *
    (Ex: 999-999-9999)
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Email Address *
  • Gender
  • Cell Phone *
    (Ex: 999-999-9999)
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *

  • What is the best time of day to receive a phone call from our Admissions staff (check all that apply)?
    *

  • Who is submitting this request for more information?
    *

  • How did you hear about Lutheran East
    *
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Email Address
    Gender
  • Grade Level of Interest *
    School Year *
  • Current School

    Other:
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •