St. Luke Lutheran Church &
Early Childhood Center
Dix Hills, NY 11746
(631) 499-8656
Rev. Dr. Roy W. Minnix, Pastor

St. Luke Lutheran Church & Early Childhood Center

 

Child Information Form & Emergency Contact Form 


Please use the link below to fill out the necessary forms we must on have on file for each enrolled child at St. Luke.
The website is safe and secure, and your forms are sent directly to us at St. Luke Preschool & Early Childhood Center.

The link:

http://www.pdfescape.com/published/?96314C1AC1D3EA82EC6B8C023D6467C06E3091A3F2F6F5AA


Thank you.

Immunization/Medical Statement

We must have immunization records for your child to attend St. Luke Early Childhood Center. That includes attending Summer program.

Please download the medical form by clicking the link below. Fill it out and mail in or bring to the preschool office
Medical Immunization Form

Automatic Debit Program for Tuition

Having your tuition automatically debited saves you time, trouble and worry. Never be late with your payments. We withdraw tuition payments from authorized accounts on the 1st of the month. You can begin using the auto debit program any time and you can stop any time and resume paying us in person. (sufficient notice must be given when stopping auto debit) Debiting ceases when the last payment of your tuition is cleared.

Download and Print the Authorization Form
Simply fill it out, attach a voided check and drop off in the preschool office or mail it in to
St Luke Preschool
20 Candlewood Path
Dix Hills, NY 11746