Application Form

School Year *

Date

Program: *

Infant

Ext. Day 7:00am-6:30pm

Full Day 8:30 am-3:OOpm

Toddlers

Ext. Day 7:00am-6:30pm

Full Day 8:30 am-3:OOpm

Half Day 8:30 am- 11:30

Beginners

Ext. Day 7:00am-6:30pm

Full Day 8:30 am-3:OOpm

Half Day 8:30 am- 11:30

Primary

Ext. Day 7:00am-6:30pm

Full Day 8:30 am-3:OOpm

Half Day 8:30 am- 11:30

2 days/week

3 days/week

4 days/week

5 days/week

Child's Information

First Name: *

Middle Name:

Last Name: *

Male

Female

Home Address: *

City: *

State:

Zip *

Birthday: *

Age: *

Email Address: *

Please list present and previous schools and/or daycare's

From:

To:

Present School:

Telephone:

From:

To:

Previous School:

Telephone:

Parent 1/Guardian

Last Name:

First Name:

Middle Name:

Home Address:

City:

State:

Zip:

Home Phone:

Cell Phone: *

Occupation/Firm:

Work Address:

Work Phone:

Parent 2/Guardian

Last Name:

First Name:

Middle Name:

Home Address:

City:

State:

Zip:

Home Phone:

Cell Phone: *

Occupation/Firm:

Work Address:

Work Phone:

Our primary goal in the admission process is to try to find the right fit between school, student, and family. Please answer the following questions to help us get a better sense of your child as a unique individual and the values around which you have built your family.

Family Information: (Check if appropriate)

Parents are:

Married

Separated

Divorced

Other

Other children in family:

Name:

Age:

School:

Name:

Age:

School:

Name:

Age:

School:

What are your goals for your child? *

What are your expectations of Children's Garden Montessori Academy for your child? *

Why did you choose a Montessori program? *

How did you learn about Children's Garden Montessori Academy? *

Please Indicate any significant illness or health condition of your child: *

Does your child take any medication(s) on a regular basis? *

Yes

No

If yes, what kind?

Please provide any further information which will help us understand your child and meet his/her needs. *