Zinnia Montessori Application

Clear Form
☐ 2019-2020
Early Care (8:00 - 9:00 am), Lunch Bunch (12:30 - 1:00 pm), and After Care (4:00 - 5:30 pm) may be added to any program for an additional fee.
☐ 5 Extended Days (8:00 am - 5:30 pm)
☐ 4 Extended Days (8:00 am - 5:30 pm)
☐ 3 Extended Days (8:00 am - 5:30 pm)
☐ 5 Full Days (9:00 am - 4:00 pm)
☐ 4 Full Days (9:00 am - 4:00 pm)
☐ 3 Full Days (9:00 am - 4:00 pm)
☐ 5 Half Days (9:00 am - 12:30 pm)
☐ 4 Half Days (9:00 am - 12:30 pm)
☐ 3 Half Days (9:00 am - 12:30 pm)

Your Child

☐ Female
☐ Male
☐ Other:

Parent / Guardian 1 (Main Point of Contact)

Parent / Guardian 2

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
☐ Karan
☐ 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$31,284$39,461$47,638$55,815$63,992$72,169$80,346
For each additional family member, add $8,177.

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.