Parent Portal PIN Request Form
STUDENT INFORMATION
PARENT MUST USE A TOUCH-CAPABLE, MOBILE DEVICE TO COMPLETE THIS FORM.
MDCPS Student ID #
*
Student First Name
*
Student Last Name
*
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Parent Portal PIN Request Form
PARENT INFORMATION & VERIFICATION
Date
/
Month
/
Day
Year
Date
Parent Name
First Name
Last Name
Parent Email
example@example.com
Verification Instructions
Using your mobile device, please sign below, take a self picture, and take a picture of your government-issued photo ID. The signatures and pictures must match. Once verified by staff, the email you provided will be used to send the Parent PIN number within 24 hours.
Parent Self Picture
*
Government-Issued Photo ID (Driver's License, Passport, ID Card, etc)
*
Parent Signature
Submit
Should be Empty: