Clear Form
☐ 2022-2023
☐ 2023-2024 School Year
☐ 2024-2025 School Year
☐ 2025-2026 School Year
Primary= ages 3-6, Lower Elementary= ages 6-9, Upper Elementary = ages 10-12
☐ Primary 5 Full Days (ages 5+)
☐ Lower Elementary (ages 6-9, 5 full days)
☐ Upper Elementary (ages 10-12 5 full days)
☐ Primary 5 Half Days (ages 4+)
☐ Primary 4 Half Days M-TH (ages 3+)
☐ Primary 3 Half Days M-W or T-Th (ages 3+)
☐ M
☐ F

Parent/ Guardian


Background information

Please list every school that your child has attended
What are your educational goals for your child? How do you see us facilitating these goals?
What role can we expect the child's parent(s)/guardian(s) to play in facilitating this child's educational goals?
Does your child have any hobbies, sports, or special interests, capabilities or talents?
How do you see your child in their social and emotional development?
Please describe your child's educational experience thus far. What has been successful? What has been challenging?
Has your child had any remedial work, special tutoring, or enlightenment classes in the past two years? Please explain.
Does your child have any special needs (educational, medical or psychological)? Has your child received any testing or had an evaluation done that would relate to their academic or social performance?
Are there any areas in which we may be able to give special help and encouragement to your child?

Medical and Emergency Information

Please list all allergies below including interventions/measures to take during possible reaction. List NONE if your child does not suffer from any allergies.

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.

If there is anything else you would like to include, please list it here. Keep in mind that this is an application only, this is not an enrollment or confirmation of acceptance into DPM. Dancing Pines Montessori does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.