Application for Enrollment Application for EnrollmentChild's Name*Name Called*Date of Birth (MM/DD/YYYY)*Gender*Desired Start Date (MM/DD/YYYY)*Indicate application level below*Toddler (2, 3, or 5 day)Toddler (2, 3, or 5 day)PrimaryLower ElementaryUpper ElementaryToddler (2, 3, or 5 day)Parent/Guardian 1 Name*Parent/Guardian 1 Email* Parent/Guardian 1 Cell Phone*Parent/Guardian 1 Home Address*Parent/Guardian 1 Employer*Parent/Guardian 1 Occupation*Name of Parent/Guardian 2*Parent/Guardian 2 Email Parent/Guardian 2 Cell Phone*Parent/Guardian 2 Home AddressParent/Guardian 2 Employer*Parent/Guardian 2 OccupationPlease list all schools attended by the student applicant: Please list all siblings, their ages and schools currently attending:NameAgeSchool currently attending Is there a language or languages other than English spoken in your home?YesNoIf yes, what language or languages?What activities do you enjoy as a family?*If you child participates in special out of school activities, what are they?*How would you characterize you child's temperament?*What are your child's strengths/challenges?*Please share your experience level with Montessori education below, if no experience, what attracted you to it?*For older children, has your child been referred for academic testing or developmental evaluations? If yes, please explain*Does your child have any diagnosed medical conditions?*YesNoIf yes, please explain*A $50 deposit is required for this application to be processed. Checks may be sent to or dropped off at the school.*YesCheck the box beside the statement:* By signing below, I hereby make application to Village montessori school. In addition to the non refundable application fee, I understand that a non refundable registration and supply fee and last month are required at time of enrollment. I also understand that once an enrollment contract is signed, I am financially obligated to the terms of the contract unless the school recommends withdrawal. Please send $50 application fee to: Village Montessori School 1610 Woodstock Road Roswell, GA 30075 memo: application fee and child's name Parent Signature*Reset to re-sign.Date* Date Format: MM slash DD slash YYYY
