KIRKLAND MONTESSORI
Tel: 425-861-8525
Email: aauerbachs@aol.com

Pre-elementary program
Application for Enrollment

Student Name:

Birthdate:

Gender: male/female

Parental Contact
Mother:
Address:
Email: Phone:
Occupation:


Father:
Address:
Email: Phone:
Occupation:

Background Information
Names of sisters/brothers:

Any other school experience:

Allergies or medical conditions we need to be aware of:

 

Morning or Afternoon program:

Reasons for choosing the Montessori Environment:

 

Please note that this application will be considered only if accompanied by payment of the yearly non-refundable application fee by check in the amount of $25.00.

Space is limited at Kirkland Montessori. Once your application has been accepted a space is held for your child only upon payment of one month tuition in advance and current registration fee. Please mail to Kirkland Montessori, PO Box 262, Kirkland, WA 98083.

Parents signature:

Date: