Harold Lewis Center
Enrollment Forms
HLC Enrollment & Medical Forms
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Referral
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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.
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HLC Referral for Evaluation Form
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Enrollment
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Medical
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School Year 2022-23
