Online Application For Admission

Admission

Montessori Cleveland's Online Admission Form. Please complete the form. At the end you will be required to pay $50 registration fee and $200 materials fee to submit the application. If you need any assistance, please contact support@MontessoriCleveland.com

Step 1 of 10

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Child's Name:*
First Last
Child's Nick Name/Called:
Birthdate:*
Current Age:*
Gender:*
Photo of Child:*

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Social Security Number:
Health Care/Insurance:*

Birthmarks/allergies/other pertinent information:*
Child resides with:*
Name of Previous Schools Attended:*
Dates Attended:*
Name of Previous Schools Attended:
Dates Attended:

Emergency Contact:*
First Last
Phone Number*
Signature of Parent/Guardian:*
Date:*

Physician's Name:*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Office Phone Number:*

Sibling's Name:
First Last
Gender:
Birthdate:
Sibling's Name:
First Last
Gender:
Birthdate:

Mother's Name:*
First Last
Mother's Residence:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone:*
Business Phone:
Cell Phone:
Email:*
Occupation:
Business / Name of Company:

Father's Name:*
First Last
Father's Residence:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone:*
Business Phone:
Cell Phone:
Email:*
Occupation:
Business / Name of Company:

Name of persons authorized to pick up child:*
First Last
Residence:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number:*
Relationship to Child:*
Driver's License Number:*
Name of persons authorized to pick up child:
First Last
Residence:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number:
Relationship to Child:
Driver's License Number:
No child will be permitted to leave the school with any person without prior written consent from the parent/guardian listed on this form. The school will require a copy of the driver's license of all persons authorized for pick up.

How did you hear about The Montessori School of Cleveland?
Date:*
Signature:*
I understand that the registration fee and material fee are non-refundable and non-transferrable.
Registration Fee:*
Price: $50.00
Materials Fee:*
Price: $200.00
Total
$0.00