Clear Form
☐ 2021-22
☐ Toddler Community Half Day, 4 days, 8:30-11:30 am
☐ Toddler Community Half Day, M-F, 8:30-11:30 am
☐ Toddler Community Half Day plus three afternoons
☐ Toddler Community Half Day plus four afternoons
☐ Toddler Community Full Day, M-F 8:30 am-3:00 pm
☐ Children's House Half Day, M-F 8:30-11:30 am
☐ Children's House Full Day, M-F 8:30 am-3:00 pm
☐ Children's House Leadership Year, M-F 8:30 am-3:00 pm
If you chose 4 half days or fewer than 5 afternoons, please provide details about your preferred schedule.

Child

☐ M
☐ F
☐ Prefer not to answer
☐ Other:

Parent/Guardian #1

Parent/Guardian #2

Background information

Has your child been in a child care or school setting before? Please describe the experience.
Heartland appreciates and encourages family involvement in our community. How do you envision your family’s contribution to the school community?
Do you intend to enroll your child(ren) at Heartland through the Leadership (Kindergarten) Year? Why or why not?
Please indicate your likely need for Before and After Care, if any:

Please send a non-refundable $50 application fee to:
Heartland Montessori School, N8226 945th Street, River Falls, WI 54022

You can also pay electronically via PayPal at https://www.paypal.com/donate?hosted_button_id=PQF6LVSDHDS8L. If paying electronically, please include a three percent transaction fee for a total of $51.50.

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.