Mascotte Charter School ENROLLMENT FORM:  GRADE 5
This is to certify that all the information on each page of this registration form is true to the best of my knowledge and belief. Falsification of information will forfeit student's athletic extracurricular eligibility for one (1) calendar year from the date of discovery of the violation. (SB Policy 5.80). The School Board of Lake County, Florida is authorized to collect social security numbers (“SSN”) of students as set forth in Sections 1008.386 and 119.071 (5)(a) 6, Florida Statutes. The provision of a student’s SSN on the enrollment form is optional and is not required as a condition for enrollment within the District.

837.06 False official statements. - Whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his or her official duty shall be guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.
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To Register Your Child in a Lake County School, the following documentation is required:
Parent / Guardian Check List:

Verification of Custody/Guardianship (One of the following)
  • Birth Certificate
  • Court Custody Documentation

Verification of Legal Name (Parent Resource to order Birth Certificate)
  • Birth Certificate

Verification of Age see LCS Student Progression for other acceptable documents
  • Birth Certificate
  • Passport

To enter Kindergarten, a child must be 5 years old on or before September 1.

To enter first grade, a child must be 6 years old on or before September 1 and successfully completed Kindergarten.

Verification of Immunization and Physical Exam.
 • Proof of up-to-date immunizations on a DH 680 Form, which can be obtained at the Department of Health at Lake County or through your private physician.
 • Proof of Health Examination by a Physician within a year prior to initial student enrollment.

Verification of Academic History
 • Transcript
 • Withdrawal Form from previous school
 • Last report card

Verification of Special education information (if applicable)
 • Current IEP
 • Current EP
 • Current Section 504 plan

Existing Heath Conditions (If applicable)

Verification of your residence/domicile in Lake County. Per SB Policy 5.20 the following is required:
 • Valid Florida Driver’s License/ID with current physical address OR a Florida Voter’s Registration Card with the current physical address, AND
 • Any two of the following documents:
    1. Lease agreement with current physical address
    2. Bill of sale or deed for house with current physical address
    3. Homestead Exemption receipt with current physical address
    4. Utility deposit receipt with current physical address
    5. Utility bill with current physical address

Temporary Documentation Exemption: Students who lack a fixed, regular and adequate nighttime residence, have a right to immediate enrollment under the McKinney-Vento Homeless Assistance Act 42 U.S.C. 11435. A completed Student Residency Questionnaire is needed to determine eligibility. For further assistance, please visit: Families in Transition (F.I.T. Program) or call the FIT office 352-742-6964 or 352-742-6967.
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