Great Work Montessori Program Enrollment Form

Great Work Montessori Program

Enrollment Form
Application for Admission

2024-2025 Program Year
Student Name

First NameLast Name
Age
Date of Birth
What age will your child be September 2024?
Student Gender

MaleFemale
What Great Program is student applying?

Ages 5-7 Great ExplorersAges 8-11 Great CreatorsAges 12-14 Great CommunitiesAges 15- 18 Great Work
Montessori Experience

YesNo
Current Educational Setting

HomeschoolPrivate SchoolPublic School
Name of Current Educational Setting
2nd Student Name

First NameLast Name
2nd Student Age
2nd Student Date of Birth
Age 2nd Student will be in September 2024
2nd Student Gender

MaleFemale
What Great Program is 2nd student applying?

Ages 5-7 Great ExplorersAges 8-11 Great CreatorsAges 12-14 Great CommunitiesAges 15- 18 Great Work
Montessori Experience

YesNo
Current Educational Setting

HomeschoolPrivate SchoolPublic School
Name of Current Educational Setting
3rd Student Name

First NameLast Name
3rd Student Age
3rd Child Date of Birth
Age 3rd Child will be in September 2024
3rd Student Gender

MaleFemale
What Great Program is 3rd student applying?

Ages 5-7 Great ExplorersAges 8-11 Great CreatorsAges 12-14 Great CommunitiesAges 15- 18 Great Work
Montessori Experience

YesNo
Current Educational Setting

HomeschoolPrivate SchoolPublic School
Name of Current Educational Setting
4th Student Name

First NameLast Name
4th Student Age
4th Student Date of Birth
Age 4th Child will be in September 2024
4th Student Gender

MaleFemale
What Great Program is 4th student applying?

Ages 5-7 Great ExplorersAges 8-11 Great CreatorsAges 12-14 Great CommunitiesAges 15- 18 Great Work
Montessori Experience

YesNo
Current Educational Setting

HomeschoolPrivate SchoolPublic School
Name of Current Educational Setting
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother Name

First NameLast Name
Mother Mobile Number
Please enter a valid phone number.
Mother Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother Email
example@example.com
Mother Employment
Mother Work Phone Number
Please enter a valid phone number.
Father Name

First NameLast Name
Father Mobile Number
Please enter a valid phone number.
Father Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father Email
example@example.com
Father Employment
Father Work Phone Number
Please enter a valid phone number.
If Parents are separated/divorced/or widowed, please answer the following questions.
With whom does the student reside?
Who is the legal guardian?
Who will receive the programming bill?
If remarried:
Stepmother's Name
Stepfather's Name
Siblings
First Name   Last Name   Age
First Name   Last Name   Age
First Name   Last Name   Age
First Name   Last Name   Age

Others in the Household?
Does your child have an IEP?
If so, which child?
Does your child(ren) have any physical, academic, or emotional needs? If yes, please describe:
Signature

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$250 Non-refundable Application Fee

Application FeeNon-refundable

$250.00

Application Fee 2nd ChildNon-refundable

$200.00

Application Fee 3rd ChildNon-refundable

$150.00

Application Fee 4th childNon-refundable

$100.00

Total

$0.00

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Great Work Montessori Program

Application for Admission

Credit Card