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 $200.00.

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 $75.00 materials fee. Please mail to Kirkland Montessori, PO Box 262, Kirkland, WA 98083.

Parents signature:

Date: