Clear Form
☐ Primary
☐ Elementary
☐ 2020-2021
☐ 2021-2022

Child

☐ Female
☐ Male
☐ Other:

First Parent/Guardian (Main Point of Contact)

Second Parent/Guardian

Our Commitment to Equity

In line with Wildflower’s equity principle, it is important for us to understand the backgrounds of the families we seek to serve.

We use this information in aggregate to open new Wildflower schools in underserved communities, raise money to support schools and reflect on our progress to serve a diverse community.

Please share as openly as you are comfortable, for the home that the child spends the majority of their time in. Thank you.

What is the language most often spoken in your household? If none of the options below are descriptive, please select "other" for a freeform option.
☐ Arabic
☐ Armenian
☐ Bantu (Including Swahili)
☐ Begali
☐ Burmese
☐ Cantonese
☐ English
☐ French
☐ German
☐ Greek
☐ Gujarati
☐ Haitian - Creole
☐ Hebrew
☐ Hindi
☐ Hmong
☐ Italian
☐ Japanese
☐ Karen
☐ Khmer
☐ Korean
☐ Mandarin
☐ Navajo
☐ Persian (including Farsi and Dari)
☐ Polish
☐ Portuguese
☐ Punjabi
☐ Russian
☐ Serbo-Croatian (including Bosnian, Croatian, Montenegrin and Serbian)
☐ Spanish
☐ Tagalog
☐ Tai-Kadai (including Thai and Lao)
☐ Tami
☐ Telugu
☐ Urdu
☐ Vietnamese
☐ Other:
Select one or more of the options below which you feel best describe your child. If none of the options below are descriptive, please select "other" for a freeform option.
Answer YES, if your yearly household income is below these numbers:
Household Size2345678
Annual Income Threshold$31,894$40,182$48,470$56,758$65,046$73,334$81,622
For each additional family member, add $8,288.
How did you hear about the Wildflower Network and our school?
Please tell us about the child's regular adult caregivers, including parents. For each adult, include the name, relationship to the child, and current employment. Please complete for each adult who regularly cares for your child in your home or theirs.
How many children are in your family, and how old are they?
What attracts you to Montessori education? If you have any previous Montessori experience please describe it. Until what age do you plan to send your child to a Montessori school?
Tell us about your child's disposition. What is your child's temperament? What five words would you use to describe your child?
What other schools are you considering?
Has your child been referred to or seen a speech or occupational therapist, education psychologist, or other specialist? Please describe the circumstances. We request this information so as to determine how we might best serve your child.

Non-Discrimination Policy

Our school admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.