MCPS Session 1 Regional Summer School Registration
Regional Summer School Program - Montgomery County Public Schools - 850 Hungerford Drive, Room 257 - Rockville, MD 20850 - 301-279-3202

-- Complete all required fields. When you are finished, click the submit button.
-- Your completed registration form will be sent to the e-mail addresses provided on this form. Obtain all required signatures.
-- Signed and completed forms must be turned in to your counselor. Non-MCPS students only can submit via U.S. mail to
the Regional Summer School Office, Carver Educational Services Center (CESC), Room 257, 850 Hungerford Dr.,
Rockville, MD 20850. E-mailed forms will not be accepted.
-- Return of the signed registration form is required to begin the registration process.
-- Acknowledgement of the receipt of your form will be sent via e-mail.

An e-mail account is required for submission of this registration form. Notification of receipt of this registration form, course enrollment confirmation, and other important communications are sent via e-mail. Be sure to set your spam/junk filters to allow e-mail from @mcpsmd.org and @mcpsmd.net.

ID Number (six digits) *
Non MCPS students: enter 000000 for now. A MCPS ID will be assigned to you later.
Your answer
Age *
Date of Birth *
MM
/
DD
/
YYYY
Grade (Sept. 2018) *
Student's Last Name *
Your answer
Student's First Name *
Your answer
Student E-mail *
Be sure to provide an active e-mail address that you check regularly.
Your answer
Student's School Counselor
Make every effort to provide the counselor's name in order to facilitate the registration process.
Your answer
School Counselor's Email Address
Your answer
Parent/Guardian's Last Name *
Your answer
Parent/Guardian's First Name *
Your answer
Daytime Phone *
Your answer
Evening Phone *
Your answer
Parent/Guardian E-mail *
Be sure to provide an active e-mail address that you check regularly.
Your answer
Address (number & street) *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Reason for taking this course *
Are you seeking to replace honors course credit? *
If you choose yes, your counselor needs to attach to the summer school registration form verification that you were previously completed the honors course.
Student Accommodations *
On the first day of class, parents and/or legal guardians should provide the summer school site administrator with a copy of the accommodations included on the student's Individualized Education Program (IEP) or 504 Plan (if applicable). A special educator will be on site.
School Type *
Indicate which type of school you attend.
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