22-23 New Student Application

Pocatello Valley Montessori School

Session*

Program – First Preference *

☐ Toddler (18mo-3y); Full Day (8:30a-3:00a) M-F (WAITLIST)

☐ Toddler (18mo-3y); Morning (8:30a-11:30a) M-F (WAITLIST)

☐ Toddler (18mo-3y); Morning (8:30a-11:30a) M/W/F (WAITLIST)

☐ Primary (3-6y); Full Day (8:30a-3:00p) M-F (WAITLIST)

☐ Primary (3-6y); Morning (8:30a-11:30a) M-F (WAITLIST)

☐ Primary (3-6y); Morning (8:30a-11:30a) M/W/F (WAITLIST)

☐ Primary (3-6y); Afternoon (12:00p-3:00p) M-F (WAITLIST)

☐ Lower Elementary (6-9y); Full Day (8:30a-3:00p) M-F

☐ Upper Elementary (9-12y); Full Day (8:30a-3:00p) M-F

Program – Second Preference *

☐ Toddler (18mo-3y); Full Day (8:30a-3:00a) M-F (WAITLIST)

☐ Toddler (18mo-3y); Morning (8:30a-11:30a) M-F (WAITLIST)

☐ Toddler (18mo-3y); Morning (8:30a-11:30a) M/W/F (WAITLIST)

☐ Primary (3-6y); Full Day (8:30a-3:00p) M-F (WAITLIST)

☐ Primary (3-6y); Morning (8:30a-11:30a) M-F (WAITLIST)

☐ Primary (3-6y); Morning (8:30a-11:30a) M/W/F (WAITLIST)

☐ Primary (3-6y); Afternoon (12:00p-3:00p) M-F (WAITLIST)

☐ Lower Elementary (6-9y); Full Day (8:30a-3:00p) M-F

☐ Upper Elementary (9-12y); Full Day (8:30a-3:00p) M-F

Other ProgramsNote: These programs will be available if there is sufficient demand.

Before Care: Monday - Friday 7:30a.m-8:30a.m

After Care: Monday - Friday 3:00p.m-4:30p.m

After Care: Monday - Friday 3:00p.m-6:00p.m

Other:

Primary Students - Nap Time*Nap spots are limited and this spot cannot be guaranteed.

Yes

Child

Child Name

Does your child go by a different name?

Birthday

Current Age

Child Gender

Home Address

Parent / Guardian 1

Name

Address

Home Number

Mobile Number

Cell Phone Provider

Do you accept text messages? 1This feature is used for emergency closures, and reminders.

Yes

Work Number

Parent1 Email

Parent / Guardian 2

Name

Address

Home Number

Mobile Number

Parent 2: Phone Provider

Work Number

Do you accept text messages?.This feature is used for emergency closures, and reminders.

Yes

Parent2 Email

Background information

Siblings

How did you hear about us?

Previous SchoolsTransferring students must provide all school records to be considered for enrollment.

Educational GoalsWhat are your educational goals for your child? How do you see us facilitating these goals?

Parental InvolvementWhat role can we expect the child's parent(s)/guardian(s) to play in facilitating this child's educational goals?

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

Special NeedsDoes your child have any special needs (educational, medical, psychological, or behavioral)? Has your child received any testing or evaluations that would relate to their academic or social performance? PVMS must have copies of tests or evaluations that your child has taken.

AllergiesDoes your child have any allergies or medical conditions? If yes, please explain:

Medical Conditions

OtherAny other information you would like us to consider.

Potty Trained*

Yes

Have you taken a tour of the school?*

Yes

Non-Discrimination Policy

Spots are limited. Admission preference is given to children with siblings enrolled at PVMS and to
children with prior Montessori experience. All children are admitted on a probationary basis. PVMS accepts students of any race, color, nationality, ethnic origin, or religious preference.