MCMS IPAD INSTRUCTIONS Complete Your Paperwork Choose/Pay Online for Insurance Receive iPad PAID

P I N K F O R M Child First/Last Missouri City MS Child First/Last PARENT First/Last

P I N K F O R M PLEASE CHECK EITHER YES OR NO AND COMPLETE PARENT SIGN PARENT NAME PARENT NAME PARENT SIGN PARENT SIGN PARENT NAME PARENT NAME

Missouri City MS Child First/Last B L U E F O R M PARENT NAME

B L U E F O R M PARENT INFO

B L U E F O R M PARENT INITIALS PARENT SIGN

Y E L O W F R M Missouri City MS Child First/Last PARENT NAME

Y E L O W F R M PARENT INFO PARENT NAME

Y E L O W F R M INITIAL: P/G=PARENT S=STUDENT PARENT SIGN CHILD SIGN

I N S U R A C E CHILD’S NAME GRADE ID NUMBER PARENT SIGN

I N S U R A C E CHECK OPTION1 OR 2 CHECK OPTION1 OR 2 PARENT SIGN

I N S U R A C E PARENT COPY OPTION1, PAY VIA WEBSITE BELOW

I N S U R A C E