Village Montessori School Registration

Village Montessori School Registration

Please complete this form to register a new student at Village Montessori.
Student Information

Please enter the details of the student to be registered.
Student's Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
MaleFemalePrefer not to say
Grade Applying For*
Student's Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Primary Language(s) Spoken at Home
Parent/Guardian Information

Please provide details for at least one parent or guardian.
Parent 1*
Parent 2
Parent 1Parent 2Both
Emergency Contact Information

Contact details in case of emergency (other than parent/guardian above).
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Student*
Medical Information

Please provide any relevant medical information.
Does your child have any allergies? (food, medication, or environmental) If yes, please list; if no, please type N/A.
Medical Conditions
Current Medications
Physician Name & Phone
Academic and Support
IEP504 PlanSpeech TherapyOccupational TherapyAcademic InterventionNone
If yes, please explain:
Village Montessori is a private school and does not provide services under the public school IEP or 504 process. Any academic accommodations or support services are determined at the discretion of the school.
Please describe your child’s strengths and/or academic concerns:
Please describe child’s academic history including any Montessori experience:
Previous School Attended (if applicable), please provide address.
Can your child use the restroom independently? If no, what stage of the process are they in?
Additional Notes or Information
Required Uploads:
- Birth Certificate - Immunization Records - Most Recent Report Card
Upload Supporting Documents

Cancelof
Tuition and Fees
Application Fee: $35 starting June 1st for New applications
Annual (paid in full)Monthly Payment PlanStep Up Scholarship: Families are responsible for any difference between the scholarship amount and the total tuition
Florida Scholarship Information
YesNoApplied / Pending Approval
Student Scholarship ID Number
Scholarship Type
Name of Parent Account Holder in EMA system
Expected Scholarship Amount (if known)
Families utilizing Step Up For Students scholarships are responsible for ensuring funds are properly allocated to the school through the EMA system. Any tuition balances not covered by scholarship funds remain the responsibility of the parent/guardian.
Agreements & Permissions
I agree to abide by all school policies and handbook guidelines.I understand that submission of this form does not guarantee admission.I grant permission for emergency medical treatment if necessary.I agree to support consistent routines and communication with the schoolI grant permission for my child’s photo and video to be used for school purposes.
Parent/Guardian Electronic Signature
Date

MonthDayYear
Date
Should be Empty:

Village Montessori School Registration

Student Information

Parent/Guardian Information

Emergency Contact Information

Medical Information

Academic and Support

Required Uploads:

Tuition and Fees

Florida Scholarship Information

Agreements & Permissions