Registration

To register, please take the time to fill out the information below. This form will need to be completed for each child you have enrolled at Glacial Hills Elementary.

Student First Name

Student Last Name

Gender

Birthday

Grade

Parent|Guardian Names:

Address 1:

Program

Phone

Address 2

Email 1

Phone

Email 2

Phone 2

Enrollment Start Date:

(320) 239-3840 | 320-239-2803 (fax)

610 W 6th St, Starbuck, MN 56381, USA