Seattle Lutheran High School

Student Name:*

First Last

Student Graduation Year*

Student Email:*

Student Mobile Phone

Student Address:*

Street Address Address Line 2 City State ZIP Code

Student Lives with:*

Guardian Information

Parent/Guardian 1 Name*

First Last

Parent/Guardian 1 Address*

Same as Students' Address

Street Address Address Line 2 City State ZIP Code

Parent/Guardian 1 Phone*

Parent/Guardian 1 Email*

Parent/Guardian 2 Name

First Last

Parent/Guardian 2 Address

Same as Student Address

Street Address Address Line 2 City State ZIP Code

Parent/Guardian 2 Phone

Parent/Guardian 2 Email

Emergency Contacts

Emergency Contact 1 Name*

First Last

Person to notify in case of emergency if parent/guardian may not be reached

Emergency Contact 1 Relationship*

Emergency Contact 1 Phone*

Emergency Contact 2 Name*

First Last

Person to notify in case of emergency if parent/guardian may not be reached

Emergency Contact 2 Relationship*

Emergency Contact 2 Phone*

Medical

Physician's name*

First Last

Physician's phone*

If your student has sustained injuries, concussions or sprains in the past two years, please note specifics here.

If your student has allergies or chronic health problems, please state details here.

If your student takes medication on a regular basis, oral or injected, please list here.

Consent to Care and Medical Treatment: By checking the box below, I authorize and consent to medical, surgical, dental and hospital care, treatment and proceedures to be performed for my student by a licensed physician, dentist or hospital when deemed immediately necessary or advisable by the physician to safeguard my student's health and I cannot be contacted. I waive my right of informed consent to such treatment.*

Yes

Name of student's medical insurance company

Medical insurance policy number

Class Registration

Only one Zero Period (8:00-8:40) class may be taken.

AP courses are specifically designed to provide challenging, college-level coursework for willing and academically prepared high school students. Permission from course instructors and summer work are required for AP course registration.

Washington State requires seniors to take a math or Algebra-based science course; if you are a senior, please be sure to include at least one in your schedule.

All courses have the option to build an HONORS component. This is available upon the request of the student and recommendation of the teacher or teacher evaluations if student is new. An honors course is designed to require more study and work than standard courses.

Please indicate your athletic interests below This is not an obligation to participate in athletics but will give the AD an idea of interest and planning needs for each sport. Thank you.

Athletic Interests

English*

All English classes are year-long.

Math*

All Math classes are year-long. Rising Seniors, please know the state requires four years of math or Algebra-based science for graduation.

*The Calculus course will take the students through the concepts of Calculus and allow them to invest more time in the concepts for solid mastery of the subject matter.

Science*

All 9th graders take Physical Science, which is one semester. All other science classes are year-long. Rising Seniors, please know the state requires four years of math or Algebra-based science for graduation.

English Other (Write In)

Science Other (Write In)

Religion*

All religion classes are one semester.

Social Studies*

All social studies classes are year-long. Contemporary World Cultures and Problems is required for Seniors.

Fitness*

All 9th graders are required to take Health and Fitness classes, each are one semester. All fitness classes are one semester. Participation on athletic teams may be used for Fitness credits.

Religion Other (Write In)

Social Studies Other (Write In)

Fitness Other (Write In)

World Language*

All world language classes are year-long. On-line classes may be taken during Zero Period or another period during the day as a student's schedule allows.

Fine Arts*

Art classes are listed in order of progression and are one semester. Band, however, is a year-long Zero Period course.

Electives (first choice)*

The following electives are year-long: Newspaper, Yearbook and AP Psychology. All other electives are one semester long.

Fine Arts Other (Write In)

Electives (second choice)*

The following electives are year-long: Newspaper, Yearbook and AP Psychology. All other electives are one semester long.

Electives (third choice)

The following electives are year-long: Newspaper, Yearbook and AP Psychology. All other electives are one semester long.

Occupational Ed - Seniors only

All seniors are required to take Life Skills class.

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