2024-2025 Pre-application Packet

Links to each page in the Pre-Application Packet for Siskiyou (SCOE) State Preschool. All documents must be completed in full and signed. The cover letter lists the documentation that must be included with the packet in order for it to be processed. The Pre-Application Packet can be mailed to:

Siskiyou (SCOE) State Preschool

609 S. Gold Street

Yreka, CA 96097

Attn: Amanda Elsemore

If you prefer to drop off the paperwork, please call Amanda at 530-842-8409 to schedule a time to drop it off. 

License #475402239

Cover Letter

Immunization Requirements

ID and Emergency Form

Child's Preadmission Health History

Notification of Personal Rights

Notification of Parents Rights

Physician's Report - Fill Out Part A ONLY

Medical Consent Form A

Medical Consent Form B

Family Intake Form

Pesticide Form

Consent Form