Please complete the following information about your household

* REQUIRED DATA

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User Name (up to 50 chars)
Password (up to 50 chars)
Re-Type to Confirm
Sponsor Information
Who is the Sponsor?
- If dual military, sponsor = highest ranking
- If military + civilian, sponsor = military
- If dual civilian, sponsor = your choice
Name of Sponsor (First)
Name of Primary Guardian (Last)
Gender
Mailing Address
Apt #
City
State
Postal/Zip Code
Housing
Home Phone (xxx)xxx-xxxx
Cell Phone (xxx)xxx-xxxx
Work Phone (xxx)xxx-xxxx
Work Extension
Sponsor Email Address (AKO Preferred)
Re-type to Confirm Email Address
Military/Civilian Status
If Military, Branch
If Military, Grade/Rank
Spouse Information
Check Here if No Spouse
Name of Spouse (First)
Name of Secondary Guardian (Last)
Gender
Cell Phone (xxx)xxx-xxxx
Work Phone (xxx)xxx-xxxx
Work Extension
Spouse Email Address
Military/Civilian Status
If Military, Branch
If Military, Grade/Rank
Emergency Contact Information
What are Emergency Contacts?

Two people (other than parents)
being within no more than one hour driving distance
we can contact and/or release your
child to in case of an emergency.

	Name of Emergency Contact (First)	Name of Emergency Contact (Last)	Contact Home Phone w/ area code	Contact Work Phone w/ area code	Contact Cell Phone w/ area code	Relationship
#1
#2

***To expedite your registration process, please request care on militarychildcare.com ***.