Please note: You may only complete this form ONCE. Please do not complete this form until all
information is collected and is accurate.
Part 1: Student Information
Student ID Number _______________________________
Student First name _______________________________
Student Last name _______________________________
Name for Diploma. This needs to be the full, legal name, including full middle name.
_______________________________
Phonetic Spelling of first and last name ( ) _______________________________
Name of Parent/guardian completing this form _______________________________
Parent/guardian phone number _______________________________
Parent/guardian email address _______________________________
Graduation Gown order:
Height _______________________________
Weight _______________________________
Part 2: Ticket Request
Each graduating student is entitled to four (4) tickets for family and friends to attend the graduation
ceremony. We understand that some families may need a greater number of tickets. If extra tickets are
available after all families receive four tickets, tickets will be distributed based on the information entered
on this form. Please note on the form below whether or not you require less than the allotted four tickets.
Graduating seniors do not need a ticket so please do not include them in the ticket count.
I will require _____ tickets (there will be check boxes for 4, 3, 2, 1 or “0/My child does not plan to
participate in the graduation ceremony”).
Special Seating Request
Special seating requests, such as wheelchair accessibility, translation services, or sign language interpreters,
are included in the initial count of four tickets, not in addition. Please note that anyone with special seating
requests can be accompanied by only one person in your group.
Please indicate the exact # of people needing the service. Do not include the companion seat. We will
add a seat for someone to assist them.
Floor seats (canes, walkers, difficulty climbing stairs, etc.) #: _____
Wheelchair spaces #: ______
Sign language services #: _____
Translation Services: # of headsets: _______
Language (historically, MCPS provides Spanish and Chinese translation only): ____________________
Other needs/requests/information: ___________________
Extra Ticket Request
If extra tickets are available, I would like to request ____ extra tickets.
Questions? Please contact Mrs. Christy Rice, Graduation Coordinator, at Christina_M_Rice@mcpsmd.org