Applicant Information
Child’s Name Last Name
First Name
Middle Name
Date of Birth:
Home Address:
City
State
Zip Code
School District
County
Education Programs: Programs run Monday through Friday, August through mid-June. Summer Camp sessions at added costs are available. A non-refundable registration fee of $75 per family must accompany application. If accepted, a contract will be prepared for signing.
Toddler (12 -36 Months Old)
Primary 3-6 Years Old (5 days a week)
Mornings 7:30-8:30 Drop off time:
Afternoons 3:00-5:30 Pick up time:
Record of previous school(s) or daycare(s) attended. If your child has attended another school or daycare, transcripts and/or school progress reports are required. Reports of any educational or psychological tests given within the last 3 years should be included. Schools previously attended (indicate school now attending, if any):
School/Daycare
Dates Attended
Address
Phone #
Please let us know any pertinent medical facts (such as allergies, potential communicable diseases, physical impairments, treatment for emotional concerns or special disabilities), and information involving adoption, divorce, or family relocation.
Parent/Guardian Information
Parent/Guardian 1
Last Name
First Name
Middle Name
Address (if different from child’s)
City
State
Zip Code
Employer
Email
Cell Phone
Work Phone
Parent/Guardian 2
Last Name
First Name
Middle Name
Address (if different from child’s)
City
State
Zip Code
Employer
Email
Cell Phone
Work Phone
Other adults (i.e. stepparents, grandparents) with whom the child lives:
Name
Relationship
Name
Relationship
A copy of any legal arrangements concerning the student should be submitted with this application. GMS will distribute all pertinent documents (i.e., progress reports, financial statements, etc.) to all legal guardians (as specified on this application) unless legal documentation specifies otherwise.
Financial Responsibility
In signing this application, I understand that it authorizes Grace Montessori School to investigate my child’s academic record and to secure other pertinent information necessary to reach an admission decision. I also voluntarily waive the right of access to all information and materials of any kind received by the School from any source in connection with the application. I understand that misrepresenting or withholding information may jeopardize admission or enrollment to Grace Montessori School. I agree and understand that GMS is mandated by law to report any suspected child abuse. My signature below indicates that all the information provided on this application is correct, complete and honestly presented.
Signature of Parent/Guardian
Date
Submit Application
