Preschool Registration

Children are registered on a first come, first served basis. Your application is not complete until the registration fee and first month’s tuition have been received.

The following information will be emailed to a CLC employee. Please remember that email is not a secure medium. Do not sent personal or sensitive information.

Parent Information

All information required for state reporting.

First Name
Middle Initial
Last Name
Email Address
Address
City
State
Zip Code
County
Area code and home phone
Area code and work phone
Gender male female
Birthdate (dd/mm/yy)
Select one. I am an MCC employee an MCC student a parent in the community
If you are an MCC employee, do you wish to use payroll deductions for your payment?Yes No
No payroll deductions are available for the Summer semester.
If you are an MCC student, are you receiving financial assistance? Yes No
If so, what kind?

Child’s Information

First Name
Middle Initial
Last Name
Gender male female
Birthdate (dd/mm/yy)
Enrolling three year old (a.m.) four year old (a.m.) five year old (p.m.)

9/28/09