ENROLL 9-12 COPY 2 - MARTIN LUTHER JR/SR HIGH SCHOOL

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PAY
ENROLLMENT FEE HERE
-------------->

THEN COMPLETE THE INFORMATION FORM

new STUDENT ENROLLMENT FOR GRADE 9-12
in the 2025-2026 school year

Please use your bank account numbers
*if paying by credit card you must add a 5% fee

bE SURE TO COMPLETE EVERY BOX MARKED * iNDICATES A REQUIRED FIELD

* Indicates required field

Grade student will be entering *

Student First Name *

Middle Name *

Last Name *

Preferred Name *

Date of Birth: Example (01/31/2023) *

Street Address *

City *

State *

Zip *

Does student have a cell phone? *

Yes No

Student Cell Phone Number *

Name and City of School Previously Attended *

Present Church Membership: Name and City *

Is the Student Baptized? *

Yes No

Is the Student Confirmed? *

Yes No

Please indicate in which school district the student resides *

Fairmont Truman GHEC Blue Earth Maple River Madelia LCWM St James MCW JCC Other

parent/guardian-legal billing party

Legal Billing Party *

If other, please specify *

father information

Name *

First

Last

Address *

City *

State *

Zip *

Email *

Father Cell Phone Number *

Place of Employment Name and City *

Work Phone Number *

mother information

Name *

First

Last

Address *

City *

State *

Zip *

Email *

Mother Cell Phone Number *

Place of Employment: Name and City *

Work Phone Number *

Does your student have an ISP, IEP, IHO or 504 plan or received educational help? *

No Yes

If so, please explain *

Has your student been state ISP tested and diagnosed? *

No Yes

If so, please explain *

Has your student ever received treatment for chemical dependency or mental health issues? *

No Yes

If so, please explain. *

Has your student ever been suspended or expelled from school? *

No Yes

If so, please explain *

Please explain any special concerns that MLHS should be aware of: *

Please list names and ages of other children in the family *

emergency contact information *other than parent**

Name of Primary Emergency Contact *

First

Last

Phone Number *

Relationship to student *

Name of Secondary Emergency Contact *

First

Last

Relationship to Student *

Phone Number *

grandparent/special person to be included in knightlight mailings

Name *

First

Last

Address *

City *

State *

Zip *

Phone Number *

Name *

First

Last

Email *

Address *

City *

State *

Zip *

Submit

Martin Luther Jr/Sr High School PO Box 228 315 Martin Luther Drive
Northrop, MN 56075
Phone:507-436-5249 FAX:507-436-5240 E-Mail MLHS

Honoring Christ...Welcoming All

HOME
- DISCOVER MLHS >
NEW STUDENTS
CURRENT STUDENTS
PARTNERS IN MINISTRY
WAYS TO GIVE
SPECIAL EVENTS