Home About Student Life Child Care Child Care Registration If we are unable to reach you when a space becomes available, we will contact the next person on the list. Please contact us with any changes to your phone number. Once you are notified that a space is available, you will be required to pay for the first week of the next semester (this payment is non- refundable) and bring a copy of your schedule to the child care center if you have not already submitted it. You may submit your class schedule with this registration form at this time, if available. Once space is available, you must complete and return these forms: Application for Enrollment 121 Immunization Form (see MSDH's MyIR page for more information) Proof of Guardianship (birth certificate) Parent’s Class Schedule (if current not on file) Acceptance will be determined by date and time application is received. Space is limited.Child InformationName* First Middle Last Call Name Name child answers to. Child's Date of Birth* Month Day Year Would you like to add another child?* Yes No Second Child's Name* First Middle Last Second Child's Call Name Name child answers to. Second Child's Date of Birth* Month Day Year Parent/Guardian InformationName* First Middle Last Cell Phone*Home PhoneEmail* Enter Email Confirm Email Relationship to Child* Mother Father Legal Guardian Academic Status* Full-time Student Part-time Student Student ID Number (M#)* Academic or Program Major* Class Schedule UploadIf available, please provide a copy of your class schedule.Max. file size: 5 MB.
