Little Village Montessori Application Form

Submission

MonthDayYear

Little Village Montessori
Child Development Center

7126 SE Milwaukie Ave. Portland, OR 97202

Phone: (503) 567-9436 Email: littlevillagemontessori1@gmail.com

www.littlevillagemontessori.com

Little Village Montessori Wait List Application

Thank you for your interest in Little Village Montessori! Please fill out the form below to the best of your ability. Your answers will help us determine how best to support your child's and family's needs.

Child's Name

First NameLast Name

Nickname

Child's Pronouns

Birth Date

MonthDayYear

Age Group

We offer a year-round, full-time program.

Our Standard Hours are Monday - Friday, from 8:30am - 3:00pm.

Standard Tuition for Infant Care (2026-27) is $2295 per month for 12 months.

Standard Tuition for Toddler Care (2026-27) is $1770 per month for 12 months.

Standard Tuition for Primary Care (2026-27) is $1445 per month for 12 months.

We offer Extended Morning Care from 7:30am - 8:30am for an additional $180 (Infant/Toddler) and $155 (Primary) per month (2026-27).

We offer Extended After Care from 3:00pm - 6:00pm for an additional $470 (Toddler) and $395 (Primary) per month (2026-27).

*We do not provide After Care for Infants.*

Schedule Needs

Please indicate your intended length of stay at LVM:

Preferred Start Date

Parent's Name:

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Number

Format: (000) 000-0000.

Cell Number

Format: (000) 000-0000.

Work Number

Format: (000) 000-0000.

Email

example@example.com

Employer and Occupation

Parent's Name:

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Number

Format: (000) 000-0000.

Cell Number

Format: (000) 000-0000.

Work Number

Format: (000) 000-0000.

Email

example@example.com

Employer and Occupation

Siblings' Names and Ages

Do you have another child you wish to enroll?

If yes, please enter their name and age below. You will need to submit a separate form for each child.

Please list the names and relationships of all other persons living in the child's home:

Are the child's parents

Is your child regularly cared for by someone other than the parents? If so, please explain:

Is your child on any medications or have any allergies?

Is your child under the care of a physician, psychiatrist, therapist, or psychologist?

What do we need to know about your child that would help us optimize their learning experience? What do you find most endearing about your child? What do you find most challenging?

Do you have any special concerns about your child's health or development?

Please list child's previous school or daycare experience:

Have you had previous association with or knowledge of the Montessori teaching method? If yes, please describe:

What are your expectations regarding your child's learning experience at LVM?

How does your child respond to correction or discipline?

How does your child interact with peers and adults?

Has your child had any difficulties in school? If so, what supports have you and/or the school provided?

Is your child potty-trained (required for Primary program)?

Does your child nap? (Children are offered a nap until they are at least 4 years old.)

How did you learn about Little Village Montessori? If referred by an LVM family, free free to share their name!