Montgomery County Child Care Support Services | Online Registration

Welcome to New Account Setup for Primary/Individual Contact

To setup your Individual or Family account please begin by completing the form below of the Parent/Primary Information. Once you have setup your account you can continue the registration or add additional people to your account from the class registration pages or through your personal My Account portal.

Account

Required fields are denoted by *--. You are in the Account section. Continue to tab below to start reading or entering your information.

* Account Type

Personal Info

Required fields are denoted by *--. You are in the Personal Info section. Continue to tab below to start reading or entering your information.

* Job Type/Relationship

How did you hear about us?

* Primary Language

* First Name

M.I.

* Last Name

Gender

* Username

* Password((minimum 8 characters))

* Confirm Password

Must contain an uppercase, three lowercase, a digit and a non-alphanumeric character (e.g. $ @ # %). Example "Abbbxx1#".

* Primary Number Type

* Primary Phone Number((xxx-xxx-xxxx))

Alternation Number Type

Alternate Phone Number((xxx-xxx-xxxx))

* E-mail

E-Blast Distribution List

Primary Address

--. You are in the Primary Address section. Continue to tab below to start reading or entering your information.

* Country

* State/Province/Region

* Address Line One

Address Line Two

* City

Postal Code

* Address Type