Petite Maison Montessori 2021/22 Enrollment Form
Please fill out one form per child.
First come first served, waitlist available.
All fees and tuition payments to be made on TUIO, at
https://app.tuiopay.com
You will receive an invitation to pay if and when your child(ren) is/are offered a space at Petite Maison Montessori.
Petite Maison Montessori
126 O’Connor Drive, Toronto, Ont. M4K 2K7
Tel: (416) 429-0507
Website:
petitemaison.ca
Email:
info@petitemaison.ca
* Required
Email address
*
Your email
Petite Maison Montessori- A CCMA Accredited School
Full Name of Student (Surname, Given, Middle)
*
Your answer
Age of Student
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Sex
*
Female
Male
Parent Name #1
*
Your answer
Parent Name #2
*
Your answer
Which parent will be using TUIO to pay fees?
*
Parent #1
Parent #2
Parent Cell Phone Number #1
*
Your answer
Parent Work Phone Number #1
*
Your answer
Parent Cell Phone Number #2
*
Your answer
Parent Work Phone Number #2
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Phone Number
*
Your answer
Emergency Contact Relation to Student
*
Your answer
Home Address of Family
*
Your answer
Home Phone Number
*
Your answer
Child’s Family Physician
*
Your answer
Child’s Family Physician Telephone
*
Your answer
Child’s Family Physician Address
*
Your answer
Child’s previous history of communicable diseases (Illness and Dates)
*
Your answer
Child’s Allergies
*
Your answer
Anaphylactic/EPI Pen Needed
*
Yes
No
Child’s Symptoms of Ill Health (indicate child’s usual reaction to illness e.g. high temperature, vomiting, irritability, etc.)
*
Your answer
Medical treatment drug or medication to be administered during the hours child is receiving care
*
Your answer
Special requirements for diet rest or exercise
*
Your answer
Any Special Needs (Physical/emotional/social) conditions we should be aware of?
*
Your answer
Consent Checkbox for Student Profile Information
*
By checking this box, I confirm the information and instructions are valid and give consent to Petite Maison to act according to the submitted written responses
Required
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