Enrollment Forms

HLC Enrollment & Medical Forms

2020-2021 Peer Tuition Agreement
2020-2021 Vision Examination Form
2020-2021 Dental Form
2020-2021 Physical Form
2020-2021 Emergency Medical Form
2020-2021 Preschool Enrollment Form
Referral
- HLC Referral for Evaluation Form
  Please complete the referral form if you have concerns about your child’s development. If your child is between the ages of three and five and lives within Marysville Exempted Village School district you would return the completed form to slamendola@ucbdd.org or drop it off at the Harold Lewis Center. If you reside in another school district you would turn it into that district and they would complete the evaluation. Please call 937-645-6714 if you have any questions.
Enrollment
- HLC Release of Information Form
- Peer Model Intake Form