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

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

3. 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

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

5. B L U E F O R M
PARENT INFO

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

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

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

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

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

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

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

13. I N S U R A C E