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MCE ASEP Registration Form 22-23
Complete one form per child enrolled.
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* Indicates required question
Untitled Title
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Grade Level
*
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
My child will be enrolled in ASEP for: (check 1)
*
Full Week
Occasional Days
Required
Is parent a HCSD Employee?
*
Yes
No
Do you have another child enrolled in another ASEP in Harris County?
*
Yes
No
If yes, which school?
Your answer
Street Address
*
Your answer
City, State
*
Your answer
Zip
*
Your answer
Main Contact #1 Name:
*
Your answer
Main Contact #1 Relationship to Student:
*
Your answer
Main Contact #1 Cell/Home Number:
*
Your answer
Main Contact #1 Work Number:
*
Your answer
Contact #2 Name:
Your answer
Contact #2 Relationship to Student:
Your answer
Contact #2 Cell/Home Number:
Your answer
Contact #2 Work Number:
Your answer
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