* Required

Please fill out the following questions to begin the Lighthouse School application process.

Parent/guardian first name:*required

Parent/guardian last name:*required

Parent/guardian email address:*required

Parent/guardian phone number

Student first name:*required

Student last name:*required

Age of student:*required

Grade of student:*required

What schools has the student attended?*required

When are you hoping to enroll?*required

Why are you interested in Lighthouse School?*required