2023-2024 Lake Preschool Pre-Registration

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If your child currently attends Lake Preschool, you do not need to pre-register your child for the 2023-2024 school year. Pre-registration began on March 1, 2023. Lake Preschool is currently full, but we are taking applications for our wait list.

Email *

Last name of child. *

First name of child. *

Middle name of child. *

Birth Date (Month/Day/Year) *

YYYY

Gender *

Male

Female

Address *

Session Preference *

AM 8:10-11:10

PM 11:40-2:40

No Preference

Child Lives with *

Mother

Father

Both

Guardian

Legal Custodial Mother/Guardian - Full Name *

Legal Custodial Mother/Guardian - Address *

Do you live in Lake School District?

Yes

Clear selection

Legal Custodial Mother/Guardian - Email *

Legal Custodial Mother/Guardian - Home Phone *

Legal Custodial Mother/Guardian - Cell Phone *

Legal Custodial Father/Guardian - Full Name *

Legal Custodial Father/Guardian - Address *

Legal Custodial Father/Guardian - Email *

Legal Custodial Father/Guardian - Home Phone

Legal Custodial Father/Guardian - Cell Phone

Do you have any other children who are enrolled in the Lake School system.

Yes

Clear selection

Will your child be 4 years old by October 1, 2023? *

Yes

If yes, you may qualify for a Grant placement into the program as long as your income is below 200%, according to the Federal Income Guidelines. If your child does not meet the age requirement, your child may only be considered for our Non Grant program, and will pay full tuition (ages 3-5).

2023 FEDERAL POVERTY GUIDELINES

1. Number of members living in your household including yourself: *

2. Enter your yearly gross family income before taxes: *

3. What program do you feel your child would be eligible for according to the guidelines listed above? *

Non Grant program (ages 3-5) over 200% on income guidelines

Grant (4 years old by October 1, 2023) AND income is below 200% of income guidelines

OR, I have concerns for my child and feel they may qualify to receive specialized education

Do you have any concerns regarding your child's development in any of the following areas, if so please explain:

Vision concerns *

Yes

If yes, please explain concern (vision):

Hearing concerns *

Yes

If yes, please explain concern (hearing):

Language concerns *

Yes

If yes, please explain concern (language):

Socialization concerns *

Yes

If yes, please explain concern (socialization):

Frequent ear infections *

Yes

If yes, please explain concern (ear infections):

Any medical diagnosis? *

Yes

If yes, please explain concern:

Mobility concerns *

Yes

Required

If yes, please explain concern (mobility):

Significant injuries? *

Yes

If yes, please explain concern (injuries):

Hospitalizations? *

Yes

If yes, please explain concern (hospitalizations):

Other health concerns? *

Yes

If yes, please explain concern (health):

Have had chicken pox? *

Yes

If yes, please explain concern:

Has your child received any therapeutic services (e.g. speech/language, counseling, occupational therapy)? *

Yes

If yes, please list types of services, length of services and by whom. Please email copy of report(s) if available to chankish@lakeschools.org

Thank you for completing the 2023-2024 Lake Preschool Pre-Registration. You will be notified via email for next steps in the registration process.

A copy of your responses will be emailed to the address you provided.

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