Application

Clear Form

Session*

Classroom*

Select the classroom your child will be entering.

☐ Road Runners Toddler (2-3y): Four Day (8:00a-3:00p)

☐ Road Runners Toddler (2-3y): Five Day (8:00a-3:00p)

☐ Kit Foxes Primary (3-5y): Four Day (8:00a-3:00p)

☐ Kit Foxes Primary (3-5y): Five Day (8:00a-3:00p)

☐ Aspens PreK/Kindergarten (4-6y): Five Day (8:00a-3:00p)

☐ E1 (1st and 2nd Grade): Five Days (8:00a-3:00p)

☐ E2 (3rd and 4th Grade): Five Days (8:00a-3:00p)

☐ E3 (5th and 6th Grade): Five Days (8:00a-3:00p)

Child

Child Name

Preferred First Name

Birthday

Child Gender

Parent / Guardian 1

Name

Address

Home Number

Mobile Number

Work Number

Parent1 Email

Parent / Guardian 2

Name

Address

Home Number

Mobile Number

Work Number

Parent2 Email

Background information

Current School Name

Years Attended

Teacher Name

School Address

Previous School

Years Attended at this school

Siblings

Will you be applying for financial aid?

How did you hear about us?

Name of Persons who referred you to DMS, if applicable

Educational Goals

What are you looking for in a school for your child?

Please answer the following questions as honestly and completely as possible.

What are three words you would use to describe your child?

Hobbies & interests

What activities does your child enjoy outside of school?

Strengths

What are your child's strengths?

Struggles

What are your child's struggles?

Does your child have any learning differences or learning disabilities? If yes, please describe.

Has your child ever been assessed as gifted? If yes please provide details.

Does your child have an IEP or 504 Plan with the public school system? If yes, please describe and provide a copy of the report.

Does your child currently recieve any special services or outside support (speech, occupational, physical, or psychological counseling or academic tutoring)? If yes, please describe.

Has it ever been suggested that your child receive recommended services or outside support?

Is there anything else that would be helpful for us to know about your child or family?

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.

Signature

*My signature confirms that all the information provided in this application and in other related documents is true and correct to the best of my knowledge, and that I have not intentionally omitted or misrepresented information that is relevant to my child’s application to Desert Montessori School. *

Name

Date