Vermont Christian Schools
ENROLLMENT FORM

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STUDENT INFORMATION

STUDENT LAST NAME	STUDENT FIRST NAME	STUDENT MIDDLE NAME	STUDENT NICKNAME

BIRTHDATE	GENDER	GRADE LEVEL
	Male Female	K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
PARENT INFORMATION
PARENT LAST NAME	PARENT FIRST NAME	RELATIONSHIP TO STUDENT	PHONE NUMBER	SECOND PHONE NUMBER
ADDRESS	APT#	CITY	ZIP	EMAIL
Special needs/requests