Council Oak Application Form

WHERE DID YOU HEAR ABOUT US?
NAME OF CHILD*
BIRTHDATE
MM
DD
YYYY
AGE
CHILDREN'S HOUSE:
3- 6 (1/2 Day) 3- 6(Full Day) 3- 6 (All Day)

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ELEMENTARY PROGRAM:
6-9 CLASS (ages 6-9) 9-12 CLASS (ages 9-12) 12-15 CLASS (ages 12-15)

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WHEN DO YOU WISH TO ENROLL AT COUNCIL OAK?
PARENT (OR GUARDIAN)
Email*
HOME ADDRESS
Street Address City State ZIP Code
HOME PHONE
MOTHER’S CELL
FATHER’S CELL
BUSINESS/PROFESSION
NAME OF FIRM
BUSINESS ADDRESS
Street Address City State ZIP Code
BUSINESS PHONE
MOTHER(OR GUARDIAN)
Email
HOME ADDRESS
Street Address City State ZIP Code
HOME PHONE
BUSINESS/PROFESSION
NAME OF FIRM
BUSINESS PHONE
BUSINESS ADDRESS
Street Address City State ZIP Code

NAMES OF SIBLINGS BIRTHDATES SCHOOL NOW ATTENDING

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CHILD'S PREVIOUS SCHOOL EXPERIENCE:
NAME OF SCHOOL
PHONE
DATES OF ATTENDANCE
Date Format: MM slash DD slash YYYY
SCHOOL ADDRESS
Street Address City State ZIP Code
I AUTHORIZE THE RELEASE OF ANY INFORMATION OR RECORDS FROM THE ABOVE SCHOOL TO COUNCIL OAK MONTESSORI.
DATE
Date Format: MM slash DD slash YYYY
PARENT SIGNATURE

Please describe your child's temperament, social relations, interests and special problems.
Has the child been tested for any psychological, emotional or behavioral difficulties or is there reason to be concerned about any of these?
What are the child's academic strengths and weaknesses?
What are the child's social strengths and weaknesses?
Is there anything the school should know about the child's health?
How do you think the Montessori system will benefit your child?
How did you choose this school for your child?
How did you first learn about this school?

A NONREFUNDABLE APPLICATION FEE IS REQUIRED WITH THIS APPLICATION.
DATE
Date Format: MM slash DD slash YYYY
Application Fee
SIGNATURE
Council Oak Montessori School does not discriminate in admissions or placement on the basis of sex, race or creed. Acceptance is based on family commitment to Montessori education and the child's likely long-term attendance at Council Oak. Admission preference will be given to children who have siblings enrolled at Council Oak and to children with previous Montessori experience. All children are admitted on a probationary basis.

6-9 CLASS (ages 6-9)	9-12 CLASS (ages 9-12)	12-15 CLASS (ages 12-15)

3- 6 (1/2 Day)	3- 6(Full Day)	3- 6 (All Day)

NAMES OF SIBLINGS	BIRTHDATES	SCHOOL NOW ATTENDING

CHILD'S PREVIOUS SCHOOL EXPERIENCE: