Clear Form

Student Information

☐ not currently enrolled in school
☐ 3 year old preschool
☐ 4 year old preschool
☐ Kindergarten
☐ 1st grade
☐ 2nd grade
☐ 3rd grade
☐ 4th grade
☐ 5th grade
☐ 6th grade
☐ 7th grade
☐ Other:
☐ M
☐ F
☐ prefer not to identify
☐ Extended Day (includes after care)
☐ Full Day
☐ Half Day (3 & 4 year olds only)
☐ 2020-21
☐ 2021-22

Parent / Guardian 1

Parent / Guardian 2

(if different than above)

Background information

Please also list additional schools that your child has attended
Does your child have any special needs (educational or medical)?
Does your child currently have an IEP?
Please share with us some reasons why your student/family is interested in Roots Montessori:
If yes, we recommend you complete our application for Financial Assistance on the FACTS website. A link to the application can be found on our website (on the Financial Assistance page).

Roots Montessori does not and shall not discriminate on the basis of race, color, religious beliefs (creed), sex, gender, gender expression, sexual orientation, age, national origin (ancestry), disability or handicap, citizenship status, marital status, or military status in any of its Admission, Educational, Financial Assistance or Employment decisions. This non-discrimination applies to staff, students and their families. We are committed to providing an inclusive and welcoming environment for our staff, students and families.

By typing your name in the box below, you attest that the information provided in this application is an honest and accurate representation.