Apply to Casa Montessori – Primary Program (Ages 2.5–6)

Child Information

Child's full name

Date of birth

Month

Day

Year

Desired start date

Parent/Guardian name

Phone number

Email address

Home city

What hours will you need early and/or late care?

What is most important to you about your child's care & education?

Has your child attended a Montessori, childcare or preschool setting before?

Yes

No

Is your child:

Fully toilet independent

Occaisionally needs reminders

Not yet

Does your child have any diagnosed medical or developmental needs we should be aware of?

Yes

No

Please provide details about medical or developmental needs

How did you hear about us?

Please fill out a separate form for each child you wish to enroll

I understand submission of this form does not guarantee enrollment and that Casa Montessori will contact me regarding next steps.