Mill Creek Towne Elementary Kindergarten Registration Information
Email address *
Child's LEGAL name (what appears on the birth certificate) *
Your answer
Preferred Nickname
Your answer
What gender is your child? *
Will Your Child be 5 before September 1, 2018? *
Child's Date of Birth (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Parent/Guardian Name (Primary Contact) *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Name (Secondary Contact)
Your answer
Parent/Guardian Phone Number
Your answer
Parent/Guardian Email
Your answer
Street Address *
Your answer
City, State, Zip *
Your answer
Has child attended any MCPS program such as EEP or Head Start? *
Other children attending Mill Creek Towne? (name/grade) *
Your answer
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