Application

Session*

Program*

Your Child

Child Name *

Birthday*

Child Gender*

Parent / Guardian 1 (Main Point of Contact)

Name *

Parent / Guardian 1 Pronouns

Parent/Guardian 1 Email*

Address*

Is this the child's primary address?

sim

Não

Home Number

Mobile Number*

Work Number

Parent / Guardian 2

Name

Parent / Guardian 2 Pronouns

Address

Home Number

Mobile Number

Work Number

Parent/Guardian 2 Email

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.

Home LanguageWhat 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

☐ Outros:

Race/EthnicitySelect 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.

Does your family qualify for a free or reduced priced lunch subsidy?

Answer YES, if your yearly household income is below these numbers:

Household Size	2	3	4	5	6	7	8
Annual Income Threshold	$32,227	$40,626	$49,025	$57,424	$65,823	$74,222	$82,621

For each additional family member, add $8,288.

sim

Não

How did you hear about Snowdrop Montessori?

Why would you like your child to attend Snowdrop Montessori?

Does your child have a sibling enrolled at a Wildflower School in Haverhill, MA?

Yes, my child has a sibling enrolled at Marigold Montessori

Yes, my child has a sibling enrolled at Wisteria Montessori

No, we have applied for a sibling to enroll at Marigold Montessori or Wisteria Montessori and are waiting for an enrollment decision

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.