Enrollment Application

Child

Child Name *

Does your child have a nickname?

Birthday*

Child Gender*

Session*If you are interested in enrolling after the start of a school year, please indicate in the "Additional Information" section at the end of this form.

Program*All of our Programs are 5 days/week. Please choose the program corresponding to your child's age at desired start date. Children must be independently toileting for enrollment in our Primary Program.

Enrollment Preference*

Are you interested in year-round enrollment?*Year-round enrollment includes: summer camp, intersessions and teacher work days.

Yes

Parent/Guardian Information

Child lives with*

Both Parents

Parent 1

Parent 2

Other:

Parent/Guardian 1

Name *

Address

Mobile Number*

Alternate Number

Parent 1 Email*

Parent 1 Occupation/Employer

Parent/Guardian 2

Name

Address

Mobile Number

Alternate Number

Parent 2 Email

Parent 2 Occupation/Employer

If relocating, when will you be moving to area?

Names & Ages of siblings and other family members living with your child*

Language(s) spoken at home*

Did you attend an in-person or virtual school tour?*A school tour is part of the admissions process to help parents make an informed decision. If you haven't toured yet, please sign-up on our website.

Yes

Contacts

A child will only be released to the parents/guardians listed above. The child can also be released to the following individuals, as authorized by the person who signs this application. In the event of an emergency, if the parents/guardians cannot be reached, Topsail Montessori has permission to contact the following individuals.

Emergency ContactsPlease list 3 people.

Name	Relationship	Phone Number

Health Care Needs

For any child with health care needs that require specialized health services (e.g., allergies, asthma, or other chronic condition), a medical action plan should be attached to the application. The medical action plan must be completed by a parent or health care professional.

Is your child on a Medical Action Plan?*If yes, it must be emailed to admissions@topsailmontessori.com to complete your child's application.

Yes

List any allergies and the symptoms and type of response for the allergic reaction:

List any health care needs or concerns, symptoms and type of response needed:

List any types of medication taken for health care needs:

Share any other information that has a direct bearing on ensuring safe medical treatment for your child:

Child's Doctor:

Doctor's Phone Number:

Hospital Preference:

Prior School Experience

Has your child had any previous school/daycare experience?

Yes

Did they attend a Montessori school?

Yes

For Elementary-aged applicants, a copy of your child’s school records are required. Please include homeschooling experience. To ensure we have a complete school history, send any additional schooling information to the Admissions office.

Previous Schools

Name of School	Location	Dates Attended

What's a typical day for your child?*

Social/emotional development*Describe your child's personality and temperament.

Toileting Independence*Please share your child's level of toileting independence:

Educational Experience*Please describe your child's educational experience thus far. What has been successful? What has been challenging?

Hobbies & interestsShare your child's hobbies or special interests.

Special Needs*Does your child have any special needs (educational, medical, or psychological)? Has your child received any testing or evaluations that would relate to their academic or social performance? If so, please provide us with copies of all tests or evaluations that your child has taken.

Special Help And EncouragementAre there any areas in which we may be able to give special help and encouragement to your child?

Why Topsail Montessori?

Why are you interested in your child attending Topsail Montessori?*

What do you value most about your child's educational experience?*

How do you think your child would benefit from attending a Montessori school? *

How long do you anticipate your child remaining at Topsail Montessori?*

Until Kindergarten

Through Kindergarten

Through Elementary

Other:

Educational Goals*What are your educational goals for your child? How do you see us facilitating these goals?

Parental Involvement*Establishing a strong home/school partnership is critical to your child's success. What role can we expect you to play in facilitating your child's educational goals?

Additional InformationIf there is additional information you would like to share, please indicate below.

PLEASE READ & INITIAL BELOW

I hereby make an application for admission to Topsail Montessori. I will pay the $100 application fee after receiving the PayPal payment link. Both the application and $100 application fee must be received to process the application. I understand this fee is non-refundable and will NOT be applied toward tuition or fees. I affirm that the statements made on this application for admission are true and complete to the best of my knowledge. If any statements are found to be false, this is grounds for dismissal from the school with no discount in financial obligation.

Parent/Guardian 1 Initials*

Parent/Guardian 2 Initials

Non-Discrimination Policy

We value diversity among our students. We do not discriminate in our enrollment policies on the basis of race, color, gender, religion, sexual orientation, national or ethnic origin.