Copy of Application

Clear Form

Today's Date*

Session*

Program*

☐ Toddler (18 mo-3 years) Monday, Tuesday, Wednesday

☐ Toddler (18 mo-3 years) Wednesday, Thursday, Friday

☐ Toddler (18 mo-3 years) 5 days

☐ Primary (3-6 years) Half-Day

☐ Primary (3-6 years) Full-Day

☐ Primary (Kindergarten) Full-Day

☐ Lower Elementary (Grade 1)

☐ Lower Elementary (Grade 2)

☐ Lower Elementary (Grade 3)

☐ Upper Elementary (Grade 4)

☐ Upper Elementary (Grade 5)

☐ Upper Elementary (Grade 6)

☐ Middle School (Grade 7)

☐ Middle School (Grade 8)

Child

Child Name

Birthday

Child Gender

Current School

Phone Number For Current School

Name Of Principal/Director Of Current School

Parent 1

Name

Parent 1 Home Address

Home Number

Mobile Number

Work Number

Parent 1 Employer

Parent 1 Occupation

Parent 1 Email

Parent 2

Name

Parent 2 Home Address

Home Number

Mobile Number

Work Number

Parent 2 Employer

Parent 2 Occupation

Parent 2 Email

Background information

Are Both Parents Living?

Yes

Status Of Parents

If Separated Or Divorced, Who Has Custody Of The Child?

Siblings

How did you hear about us?

Previous SchoolsPlease list every school that your child has attended

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

Remedial Work And TutoringHas your child had any remedial work, special tutoring, or enlightenment classes in the past two years? Please explain.

Special NeedsDoes 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? Please have copies sent of tests or evaluations that your child has taken.

Non-Discrimination Policy

Holy Trinity Montessori does not discriminate on the basis of race/ethnicity, color, national origin, sex, and disability, in the administration of any of its educational programs, admissions policies, and other school administered programs.

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