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To apply, please fill out the following form or the 2019-20 Enrollment Packet. If you have any questions or need assistance, contact Sherida Williams at (314) 531-9820 or email her at swilliams@lasallemiddleschool.org.

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• Child's Legal First Name

• Child's Legal Last Name

• Child's Preferred Name

• Child's Social Security Number

• Date of Birth (mm/dd/yyyy)

• Gender

  MaleFemale

• Ethnicity

  Black/African AmericanCaucasianHispanic/LatinoAsian/Pacific IslanderAmerican Indian/Alaska NativeOther

• Current Grade Level

  4567

• Year of Proposed Entrance

• Applying for Grade Level

  5678

• Primary Adult Parent/Guardian

• Primary Adult Parent/Guardian E-mail

• Parental Status

  ParentFosterNon-Parent

• Number in Household

• Number of Children Under 18

• Street Address

• City
• State Missouri (MO)Alabama (AL)Alaska (AK)Arizona (AZ)Arkansas (AR)California (CA)Colorado (CO)Connecticut (CT)Delaware (DE)District of Columbia (DC)Florida (FL)Georgia (GA)Hawaii (HA)Idaho (ID)Illinois (IL)Indiana (IN)Iowa (IA)Kansas (KS)Kentucky (KY)Louisiana (LA)Maine (ME)Maryland (MD)Massachusetts (MA)Michigan (MI)Minnesota (MN)Mississippi (MS)Montana (MT)Nebraska (NE)Nevada (NV)New Hampshire (NH)New Jersey (NJ)New Mexico (NM)New York (NY)North Carolina (NC)North Dakota (ND)Ohio (OH)Oklahoma (OK)Oregon (OR)Pennsylvania (PA)Rhode Island (RI)South Carolina (SC)South Dakota (SD)Tennessee (TN)Texas (TX)Utah (UT)Vermont (VT)Virginia (VA)Washington (WA)West Virginia (WV)Wisconsin (WI)Wyoming (WY)
• Zip

• Home Phone

• Work Phone

• Alternate Contact Name

• Alternate Contact Phone

• Current School Name

• Current School Street Address

• City
• State Missouri (MO)Alabama (AL)Alaska (AK)Arizona (AZ)Arkansas (AR)California (CA)Colorado (CO)Connecticut (CT)Delaware (DE)District of Columbia (DC)Florida (FL)Georgia (GA)Hawaii (HA)Idaho (ID)Illinois (IL)Indiana (IN)Iowa (IA)Kansas (KS)Kentucky (KY)Louisiana (LA)Maine (ME)Maryland (MD)Massachusetts (MA)Michigan (MI)Minnesota (MN)Mississippi (MS)Montana (MT)Nebraska (NE)Nevada (NV)New Hampshire (NH)New Jersey (NJ)New Mexico (NM)New York (NY)North Carolina (NC)North Dakota (ND)Ohio (OH)Oklahoma (OK)Oregon (OR)Pennsylvania (PA)Rhode Island (RI)South Carolina (SC)South Dakota (SD)Tennessee (TN)Texas (TX)Utah (UT)Vermont (VT)Virginia (VA)Washington (WA)West Virginia (WV)Wisconsin (WI)Wyoming (WY)
• Zip

• Phone

• Years Attended

• My child has, in the past, qualified for free or reduced lunch

  YesNoUnsure

• How Did You Hear About Us?

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