School Session

Programs

am also interested in Before and/or After Care

Yes

How did you hear about SmartStart Montessori?

If you were referred by a current or former Smart Start Montessori parent?

What other schools are you applying to?

If none, type "none"

CHILD INFORMATION

First Name

Last Name

Child Likes to be Called: Nickname

Date of Birth:*

Child Gender*

Female

Male

Ethnicity (optional)

FAMILY INFORMATION 1

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile Number

Country

(###)

###

####

Secondary Phone Number

Country

(###)

###

####

Siblings 1

First Name

Last Name

Siblings 2

First Name

Last Name

Siblings 3

First Name

Last Name

Siblings 4

First Name

Last Name

LIVING ARRANGEMENTS

Child lives with* (check ALL that apply)

Father

Mother

Stepfather

Stepmother

Guardian

Other

Provide details

Check if appropriate:

Other

Was the child adopted?*

If yes, at what age?

Who stays with the child if both parents work regularly?

When does this occur?

Dominant Language at Home

Please indicate which language is spoken MOST at home. If a blend of two or more equally, indicate that and use the next space provided to explain.

Please explain Dominant Language choice Other or More than one

Additional Addresses

Please list any addresses in addition to the child's custodial parents to which school information and reports are to be mailed.

Date

YYYY

Second

First Name

Last Name

SCHOLASTIC INFORMATION

Understanding an applicant's background helps us make informed and appropriate decisions. Please fill out this section completely, to the best of your knowledge. Prior Schooling Please list schools your child has attended and for what length of time.

Date

YYYY

Last Grade Attended* type n/a if this will be child's first school

Has the applicant ever been suspended, asked to withdraw, or expelled from a previous school?

If yes, please email an addendum letter with explanation to smartstartmontessoriforney@gmail.com. The application will not be accepted until this letter had been received.

Yes

TODDLER APPLICANTS ONLY

please list approximate dates or age for the following milestones as applicable The Smart Start Toddler program does not require a specific level of speech or toilet learning, this is just to help Guide understand where the student is starting from

TODDLER APPLICANTS ONLY - Please share any comments regarding speech development and toilet training

ADDITIONAL INFORMATION Understanding an applicant's background helps the school make informed and appropriate decisions. Please explain any special needs your child has.

Additional Information If your child has ever participated in psychological or educational assessments or counseling, please explain so we have a better understanding of his/her needs.

Medical Information Is there any health information the school needs to be aware of, including allergies, physical disabilities, speech or hearing difficulties?

Medication

Please list any medication your child takes regularly, along with specific dosage and condition treating.

EDUCATIONAL PHILOSOPHY Educational Goals*

What are your educational goals for this child? How do you see Smart Start Montessori facilitating these goals?

Parent/Guardian Roles*

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

Social/Emotional*

How do you see this child in his/her social/emotional development?

Expectations*

Is this child's general development and academic performance in his/her present school consistent with your expectations?

Areas of Encouragement*

Are you aware of any areas in which we might be able to give special help or encouragement to this child?

AUTHORIZATION

I authorize Smart Start Montessori to contact current and previous schools or other sources to obtain information to support my application. I will not seek access to confidential recommendations and/or evaluation materials provided by any source before or after admission. I understand that this application will not be accepted until the parent(s)/guardian(s) of applicant have (1) taken a tour of the campus, and (2) submitted the $100 application fee. Parent/Guardian Acknowledgement* Please type your full name in the following box, which will act as a signature acknowledgement for the above authorization.

How to Apply

Smart Start Montessori Application for Enrollment

Programs