MACCC Information Request Form
Your Name (required):
What are the ages of your children?
Age of 1st Child:
infant(6 weeks to 16 months)
toddler(16 - 33 months)
preschool(33 mo.-kindergarten)
school age(kindergarten-grade6)
Age of 2nd Child:
infant(6 weeks to 16 months)
toddler(16 - 33 months)
preschool(33 mo.-kindergarten)
school age(kindergarten-grade6)
Age of 3rd Child:
infant(6 weeks to 16 months)
toddler(16 - 33 months)
preschool(33 mo.-kindergarten)
school age(kindergarten-grade6)
Additional Children (if any):
Select the types of information you would like to receive:
Send me an enrollment packet.
Send me a current rate schedule.
Send me a list of activities and field trips.
Call me at the phone number given below.
Address:
Phone number (required):
Additional Comments:
Thank you for your request.