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Application For Enrollment

Date of Application_____________________
Name of Child: _______________________________________ Gender:_____________
(Male/Female)

Childs Birth Date: ____________________ Current Grade Level: __________________


Name of Parents: ________________________________________________________
If parents are divorced, who has legal custody? _____________________________
If parents are separated, with whom does the child live? ______________________
Address: ______________________________________________________________
Home Phone: ______________________________

Email Contact: _______________

Fathers Occupation: _____________________ Place of Employment: ________________


Work or Cell Phone: __________________
Mothers Occupation: _____________________ Place of Employment: _______________
Work or Cell Phone: __________________
Familys Religion: ___________________ Parish, If Catholic: ______________________
Has you child attended another school? _____ If yes, name of school: _________________
Why do you want your child in Old Mission Montessori School?

____________________________________________________
____________________________________________________
What do you know of the Montessori philosophy?

____________________________________________________
How did you learn about Old Mission Montessori School?
____ through friends
____ church bulletin
____ other
Thank you for your interest. Please give us a call and well be happy to schedule a tour.

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