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Request Information

Thank you for your interest in Messiah Lutheran School! We are glad to provide you with additional information, and we hope to host you for a free educational consultation and campus tour. 

Please fill out the form below and Janice Snyder, our Admissions Coordinator, will contact you and provide the information you desire and schedule your campus visit (if requested).

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone *
  • Second Parent / Guardian
    (leave blank if not applicable)
  • 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:

  • Which weekdays are best to schedule your educational consulation and tour? Mark all days that work for you. 

  • What time of day is best to schedule your educational consultation and tour? Typical visits are 45-60 minutes, but we are glad to work with your schedule if you are in need of a shorter appointment. Mark all that work for you.

  • Do you prefer an on-campus or online consultation?

  • Please share any additional information that will help us schedule your consultation and tour. We will contact you at the phone and email address you've provided to schedule your visit. 
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender
  • Grade Level of Interest *
    School Year *
  • Current School
    Other:
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •