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Adult Services and Frederick Community College Foundation, Inc.
I, certify that I am requesting reimbursement for child care assistance for the following semester.
Name:
Please choose Semester:
Fall
Spring
Summer
JTerm
I further agree that the CHILD CARE PROVIDER was selected by me, and should any problems arise concerning the well-being of my children while under the provider’s care, Adult Services will not be held responsible.
Your child care check will be mailed to the address you provide below. If you have a special circumstance, such as trouble with mail delivery or a protected address, you can make arrangements to pick up your check from Adult Services. If you want to arrange to pick up your check, you must discuss that with a staff member each time you complete this form.
Please note:
There could be a delay in receiving your check if you choose to pick up your check.
Street Address:
City, State and Zip:
Email:
If you are using your myFCC email account, your email address is the first initial of your first name, your last name, and the last three numbers of your student ID followed by @myfcc.frederick.edu.
Student ID:
Schedule an appointment
Contact
Located in Annapolis Hall
A-103
The Office of Adult Services staff can be reached by email or telephone as listed below:
Jennifer Ward
Office Manager
301-846-2483
Vacant
Director Adult Services
301-846-2484
Stacey Yost
Counselor
301-846-2485
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