Please complete this pre-registration form if your child plans to attend Kindergarten this Fall in the Lakeland School District. Due to the current health situation, the district will announce a formal future enrollment process after we have more guidance from the state of PA. The collection of information on this form is for planning purposes and DOES NOT MEAN YOUR CHILD IS ENROLLED AT LAKELAND!
What is the last name of your child?
What is the first name of your child?
What is your child's birthdate?
*You are required to present an original birth certificate upon formal enrollment.
Parent #1 name:
Parent #1 Phone number so we can contact you.
Parent #2 name:
Parent #2 Phone number so we can contact you.
Address of Primary Residence:
The child is required to live with a parent, in the district, on a full-time basis. (Must sleep there more than half of the days of the week.) PROOF OF RESIDENCE IS REQUIRED AT THE TIME OF ENROLLMENT. ALL DOCUMENTATION IS SUBJECT TO REVIEW PRIOR TO ENROLLMENT. Click here for more information regarding student enrollment.
My child will attend:
Mayfield Campus (Mayfield Borough, Jermyn Borough, Childs, Carbondale Twp. Residents)
Scott Campus (Scott Township, Greenfield Township, Justus Residents)
My child has special needs (check all that apply)
All information is CONFIDENTIAL and will only be used by Lakeland School District Office Staff. Check all that apply.
My child has no special needs
Is entering school from Early Intervention
Has food or other allergies
Has a medical condition requiring a special medical plan
Since you indicated that your child has a special need, please briefly decribe what the need is (i.e. Has a medical need and is not in Early Intervention)
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This form was created inside of Lakeland School District.