MMC Learning Center

Application For Enrollment

Supervised study for 3rd-6th graders at Millersville Mennonite Church on Thursdays and Fridays 8 AM- 3 PM from 9/10/20 - 11/20/20 (unless disrupted). Space is limited. $30 per family enrollment fee (assistance is available if needed). Please answer each question thoroughly.
1.Parent/Guardian's Name(s)(Required.)
2.Child's Name and Grade Level(Required.)
3.Name(s) of other children and grade levels you are applying for.(Required.)
4.Household Size(Required.)
5.Total Household Income (counting jobs, public assistance, SSDI, child support and food stamps)(Required.)
6.Child's Elementary School(Required.)
7.Why do you need this service? Child care difficulties? Job Schedule?(Required.)
8.Child's allergies, special needs, medical conditions, and anything else we should know. (Required.)
9.Names and work schedules of all adults in household(Required.)
10.Email Address AND Phone Number(Required.)