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MC Cyber Program Registration Form

Student Information

Building child attends:*

Answer required for "Building child attends:"

W.A. McCreery Elementary

Marion Center Jr/Sr High School

First Name

Answer required for "First Name"

Last Name*

Answer required for "Last Name"

Grade Entering*

Answer required for "Grade Entering"

Date of Birth*

Answer required for "Date of Birth"

Has your child ever been enrolled in the MC Cyber Academy?*

Answer required for "Has your child ever been enrolled in the MC Cyber Academy?"

Yes

Parent Contact Information

Name*

Answer required for "Name"

Email*

Answer required for "Email"

Day Phone #: *

Number Required

Best time and way to reach you:*

Answer required for "Best time and way to reach you:"

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"