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Elementary Admission Application

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Program Information

Elementary (6-12 years) Lower Elementary (age 6-9) Upper Elementary (age 9-12)

Student Information

First Name: *

Middle Name: *

Last Name:*

Likes to be called/Goes by:

Date of Birth:*

Gender:*

Current School (if applicable):

Does your child have siblings?

What is/are their name(s)?

Family Information

Litchfield Montessori School Family Enrollment* Prospective Families Current Families

First Parent/Guardian:*

First Name: *

Last Name:*

Relationship to Child:*

Address: *

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

Home Phone: - -

Cell Phone:* - -

Email:*

Occupation:

Employer:

Work Phone: - -

Family Status:*

Second Parent/Guardian:*

First Name: *

Last Name: *

Relationship to Child: *

Do Both Parents/Guardians Share the Same Address? *

Address: *

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

Home Phone: - -

Cell Phone:* - -

Email Address:*

Occupation:

Employer:

Work Phone: - -

Additional Questions

1. What aspects of Montessori education attracted you?

2. How did you hear about Litchfield Montessori?

3. Please share with us your goals for your child.

Financial

Name of Person financially responsible for tuition & billing:*

Is this person someone other than a Parent/Guardian?*

If so please provide the address of the responsible party:*

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

A $50 Application Fee is required, made payable to Litchfield Montessori School.

Amount $50.00

Payment Method:*

Payment Notes/Additional Info:

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Elementary Admission Application

Program Information

Student Information

Family Information

Additional Questions

Financial

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