HCCSC Preschool New Student Information

New Preschool Student Enrollment Information

This form is to be filled out for preschool students new to HCCSC.
Please note, we have limited openings for preschool and you must contact Laura Lahr before completing this form at 260-356-8312 Ext. 6152.

Completing this form does not guarantee placement in Preschool.
Grade of Student*
YesNo
Please reach out to Laura Lahr at (260) 356-8312 Ext. 6152 before filling out this form. Thank you!
The K-12 New Student Form can be found here. This form is only for new preschoolers.
Preschool is not taking applications at this time. Please reach out to Laura Lahr at: LLahr@hccsc.k12.in.us if you would be interested in your student attending preschool for the 2025-2026 school year.
Date student will start at HCCSC (First Day of 26-27 school year is Aug. 5th, 2026)*

MonthDayYear
Date
Name of School your Student will be attending?*
Grade of Student -Text
Pre-K Principal Email
example@example.com
Email of Secretary 1
example@example.com
Legal Name of Student*

First NameMiddle NameLast Name
Nickname or Child's preferred name:

First NameLast Name
Legal Gender*
Date of Birth*

MonthDayYear
Date
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address(if different than home address)
Upload Proof of Residency:

Please upload a picture of a document, a piece of mail or tax document with your current address. If you can not provided this as an attachment you will be required to bring a copy to the student's school on their first day of school or provide during enrollment.
Cancelof
Student Home Language*
YesNo
American Indian/Alaskan NativeBlackAsianHispanic and of any raceWhiteMultiracial (two or more races)Native Hawaiian or other Pacific Islander
American Indian/Alaskan NativeBlackAsianWhiteNative Hawaiian or other Pacific Islander
Country of Origin
Parent/ Guardian Email*
example@example.com
Student Lives with/Relationship to the student*
Both Parents, Mother, Father, Step-Parent, Grandparent, Foster Parent, etc...
Parent 1 - Name

First NameLast Name
Relationship to Student
Phone Number for Parent 1
Format: (000) 000-0000.
Parent 2- Name*

Last Name
Relationship to Student*
Phone Number for Female Head of Household*
Format: (000) 000-0000.
List Non Custodial Parent (if any)
Phone Number of Non Custodial Parent
Format: (000) 000-0000.
YesNo
YesNo
Day Care Provider - Name
Day Care Provider - Phone
Format: (000) 000-0000.
Day Care Provider - Address
Username for Parent PowerSchool account (login info)*
A password will be given to you by the school secretary. You will be prompted to change it when you log into PowerSchool.
Name of Previous School*
Address of Previous School *

Address

Street Address Line 2

CityState

Postal / Zip Code
Phone number of Previous School *
Format: (000) 000-0000.
Fax number of Previous School
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
Names and Grades of Siblings at HCCSC (Ex. John Smith 4th, Caroline Smith 8th, etc.)
YesNo
Today's Date*

MonthDayYear
Date
Parent/Guardian Signature*

Clear
Should be Empty:

New Preschool Student Enrollment Information