Enrollment Application
Student’s Name:
_________________________________________________________
Address:
_________________________________________________________
_________________________________________________________
Phone Number:
_________________________________________________________
Parent or Guardian’s Name:
_________________________________________________________
Office
Use Only
Date Received: ____________
Date Accepted: ____________
Lottery#: ____________
Waiting List #: ____________
______________________________________________________________________________
Dyanne Parsons
Glacial
Hills
Director
Elementary
School
320-239-3840
ISD#4168