Mountaintop Waldorf School Application for Enrollment
Child’s First Name: *
Your answer
Child’s Last Name: *
Your answer
Child's birth date: *
MM
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DD
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YYYY
Month/Year of Entry:
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Parent A Information
Parent A Name *
Your answer
Address *
Your answer
Occupation *
Your answer
Employer *
Your answer
Cell Phone *
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Home Phone *
Your answer
Work Phone *
Your answer
Email *
Your answer
Parent B Information
Parent B Name *
Your answer
Address (if different)
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Occupation *
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Employer *
Your answer
Home Phone *
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Work Phone *
Your answer
Cell Phone *
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Email *
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Program Options
Mixed Age Kindergarten offers Mornings: 9am - 12:30pm, Afternoons: 12:30pm - 3pm for 3 to 6 years of age

Little Ones class offers Mornings: 9am - 12pm, Afternoons: 12pm - 2:30pm for 18 months to 3 years of age

Parent/Child Class: 9:00am - 11:30am, Fall and Spring options for twelve weeks each, 14 months to 3 years of age

Mixed Age Kindergarten mornings
Mixed Age Kindergarten afternoons
Little Ones Class morning options
Little Ones Class afternoon options
Parent/Child Program
Please state briefly the reason(s) for your interest in this school: *
Your answer
Educational History
Has your child participated in any preschool programs? If so, please list previous school(s): *
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What is your child’s favorite activity? *
Your answer
Health History
Were there any complications during the pregnancy? If so, please provide a brief explanation. *
Your answer
Approximate length of labor: *
Your answer
Were there any complications during or immediately following the birth? If so, please provide a brief explanation. *
Your answer
Please list any major childhood illnesses your child has had: *
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Development
Did your child crawl? *
At what age did your child begin to walk? *
Your answer
At what age did your child begin to talk? *
Your answer
Does your child have any loose teeth? *
Does your child have any speech problems? If so, please explain. *
Your answer
Please list the physical activities your child likes to engage in. *
Your answer
Home and Family Rhythms
List names and ages of siblings
Your answer
Do they reside at home?
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Does your child reside with both parents? *
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How many hours of sleep does your child get each day? *
Your answer
Does your child watch TV or play computer games? If so, how much per week? *
Your answer
Thank you!
If you have any questions, please email mountaintopenrollment@gmail.com or contact Wendy Weinrich at 845-389-7322.
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