Heritage Primary School

2017-2018 Application - Child’s Information:

______First Middle Last Birth Date Gender

PREVIOUS SCHOOL EXPERIENCE HEALTH

______School or Playgroup Duration Allergies?

BROTHERS AND SISTERS

______Name and Age Name and Age MOTHER (or guardian) FATHER (or guardian) ______Mother’s name ______Father’s name ______Street Address ______Street Address ______City State/ZIP ______City State/ZIP ______Home Phone Cell Phone ______Home Phone Cell Phone ______Email Address ______Email Address ______Business Name/Phone ______Business Name/Phone

Questions about your Child

What do you believe are your child’s greatest strengths and weaknesses? ______

______

Does your child have any special needs (physically, emotionally, educationally etc.)? ______

______

What are your educational needs for your child? ______

______

Do you have any previous experience or history with Montessori Education? ______

______

Application Procedure

A tour of the Facility and an observation of our environment are required for all applicants. All applications must include a fee of $100. When your child is enrolled at Lifetime Montessori School you will be asked to submit a non-refundable $200 enrollment fee and either the yearly payment listed above (less a 5% discount) or a non- refundable tuition installment towards June of 2018. All students are required to pay the application, enrollment fee and June installment for enrollment confirmation, regardless of their tuition schedule. The application and enrollment fees ARE NOT deductible from future tuition payments. Each applicant must meet with a Teacher upon confirmed enrollment before attending school.

 I have read this application and I submit it with a non-refundable fee of $100 to Lifetime Montessori School.

______Signature of Parent or Guardian Date Lifetime Montessori School has a non-discriminatory policy relative to race, color, and national origin with respect to the admission of students and the employment of faculty and administrative staff.