MCPS Pre-School Application
Please complete this form to apply for preschool in MCPS for the 2024-2025 school year. You may be asked to provide additional income verification information in order to determine if your child qualifies for preschool based on income. 
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Child's First Name
Child's Middle Name
Child's Last Name
Name Child Goes By
Sex
Clear selection
Date of Birth
MM
/
DD
/
YYYY
Place of Birth
Race
Clear selection
Address
Phone Number(s)
Language Spoken at Home
Parent Information
Marital Status of Parents
With whom does the child live?
Father's Name
Father's Address (if different than child)
Place Employed
Mother's Name
Mother's Address (if different than child)
Place Employed
Additional Information to Assist in Placement of Children in Pre-School/Headstart
Does the child have a known disability?
Clear selection
Do you receive SNAP (food stamps) benefits? If yes, please provide your permit number. 
Do you receive Medicaid? If yes, please provide your identification number.
Estimated Monthly Gross Income
Number of People Living in Household
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