3-Year-Old Preschool Program

3-Year-Old Preschool Program

Enrollment Form
Please fill out the following information to express your interest in enrolling your child in MCCSC's 3-year-old preschool program.

Seats are limited, and completing this form does not guarantee enrollment in preferred location.

When a seat is available, you will be notified via email on the next steps of enrollment.

The following locations will provide care for 3-year-olds for the 2024-2025 school year:
- Early Learning Center
- Hoosier Hills Childcare Center
- Clear Creek Elementary
- Grandview Elementary
- University Elementary
Please contact us with any questions:

Phone: (812) 330-7702

Email: earlylearning@mccsc.edu

Thank you!

Child's Name:*

First NameLast Name
Child's Date of Birth:*

MonthDayYear
Note: Children entering MCCSC's Preschool program must turn 3-years-old by August 1, 2024
Child's Primary Residence/Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Location:*

Early Learning CenterHoosier Hills Childcare CenterClear Creek ElementaryGrandview ElementaryUniversity ElementaryNo Preference - First Available

Parent/Guardian's Name:*

First NameLast Name
Parent/Guardian's Phone Number:*
Please enter a valid phone number.
Parent/Guardian's Email Address:*
example@example.com
Parent/Guardian's Primary Residence/Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

By selecting "I accept" below, you indicate all information submitted is accurate to the best of your knowledge.*

I accept
Signature:*

Clear
Date*

MonthDayYear
Date

Should be Empty: