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Request Information

Thank you for your interest in Lighthouse 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 *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone *
Home Address
  • Street Address
  • City
  • Country
  • State
  • Zip
  • How Did You Hear About Us?
    Details:
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
  • Grade Level of Interest *
    School Year *
  • Current School

  • Does your student currently have an IEP or has had in the last 3 years?
    * Yes   No
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •