ParentConnect Application

Please complete this form in its entirety and submit it using the button at the end of the form. To protect the privacy of students, office staff will verify proof of guardianship or parental rights before you will be issued a ParentConnection account. By completing this form, you hereby request the creation of a ParentConnection account and authorize Quincy Community Schools to link your child’s/children’s information to this account. You will need to provide your drivers license or other photo ID BEFORE you receive the information for your account.

Please fill out the information below. All the parent information fields are mandatory. You must fill out 1 form PER person in the family that is requesting access. You will receive an email confirming your completed application.

 

Parent Information (1 form must be filled out for each parent requesting access)

* Designates a REQUIRED FIELD

*First Name: *Last Name:

*Address 1: Address 2: (PO Box, Suite or Apt Number)
*City: *State: *Zip Code:

*Home Phone: (Please type in the following format: 517-639-9245) * Work Phone:

*E-Mail Address: ****PLEASE SEE NOTE BELOW*****

Please enter your email address carefully.  This is the only way that you will be contacted about your ParentConnect account.  This email address MUST BE unique in our system.  Do not use the same email address as a spouse.  Your account request WILL NOT be processed if the email account provided is already on file for someone else.

 

Student Information

You may list up to five students per submission.

 
First Name Last Name School Birthdate
(mm/dd/yyyy)		 Grade Level

*I certify that I have the legal rights to view the information contained on ParentConnect for the child/children listed in the Student Information section. I also agree that the information I have supplied here is accurate to the best of my knowledge. Checking this box also acts as your hand written signature.

Clicking submit will send a request for a ParentConnection account to the Quincy Community School district. Please check all the above information again to ensure its accuracy. Please allow at least 1 week for processing.

AFTER SUBMITTING...you should be taken to a CONFIRMATION screen. If you DO NOT see the confirmation screen, then you will need to re-submit. The data has been received IF YOU are taken to the confirmation screen.