Enrollment Application

Please fill out as much information as possible.

Child's Name *

I wish to request a space for my child for the academic year beginning: *

Nickname

Date Of Birth *

Parents or Guradians *

Phone *

Address *

Address 2 *

City *

State *

Zip *

Parent #1 Name

Parent #1 Phone

Parent #1 Email

Parent #1 Address

Parent #1 Occupation

Parent #2 Name

Parent #2 Phone

Parent #2 Email

Parent #2 Occupation

Is either parent away from home for long periods of time?

Is your child cared for by anyone else?

By Whom?

What portion of the day?

In home?

Elsewhere?

Please describe your child's play activities:

Describe child’s eating habits and general diet:

Has your child attended school before?

If yes, where?

What is the reason for sending your child to Montessori school:

Other House Hold Member Name

Relationshsip

Age

Other House Hold Member Name

Relationship:

Age

Other House Hold Member Name

Relationshsip

Age

Other House Hold Member Name

Relationshsip

Age

How did you hear about West Marin Montessori School?

Further helpful comments:

Your Name: *

Date *

Email *