2018-2019 Children's House, Early Childhood Program New Student Pre-Enrollment Form
Completion and submission of this Enrollment Form does not guarantee nor quantify placement. Placement confirmation will occur in April 2018.
Please submit one form per child you wish to enroll.
Child's Last Name
Child's First Name
Child's Date of Birth
Child's Grade Placement
Preschool (Three years old by August 31, 2018 and younger than five years old prior to August 31, 2018)
Kindergarten (Must be age five by August 31, 2018)
Legal Guardian Name(s) (First and Last Name)
Contact Number for Guardian listed above
Alternate Contact Person/Phone Number
Mailing Address (Street Number, Street Name, City, Zip Code)
Does your child have previous daycare or preschool experience? Please list.
Does your child have an IEP or IFSP in place? Note: Children's House does not discriminate based on any disability, gender, race, religion or individual need. This question is solely included to accommodate for transition planning including welcoming your child into our program.
Schedule preference-please note, preferences are not guaranteed. All spaces are filled on a first come, first serve basis.
Full Day Program (Mon.-Thurs.)
Morning Half Day Program (Mon.-Thurs.)
Afternoon Half Day Program (Mon.-Thurs.)
I have read, understand and agree to abide by the information contained herein. Please check each box as you agree.
Children's House "Guiding Principles" describe our whole child, whole school and whole community approach. To support our school, each family is asked to contribute a minimum of ten Family Partnership hours during the course of the year. By submitting this registration, you agree to engage in this positive community effort.
Upon notice of placement, you will be required to complete additional paperwork including but not limited to: providing proof of immunizations, proof of a well child check up signed by a physician, enrollment documents, etc.
Submission of this form does not guarantee enrollment. Spaces are filled on a first come, first serve basis. In the event all spaces have filled, you will be contacted and placed on a wait list. Placement confirmation will be conducted in April 2018.
Tuition and associated fees: A $125.00 non-refunable registration fee is invoiced in August, a $50.00 Materials Fee in invoice once per semester. Monthly snack fees apply according to your child's confirmed schedule. Lunch fees are opt-in fee per service. Tuition Assistance can not be applied towards fees.
Send me a copy of my responses.
Never submit passwords through Google Forms.
This form was created inside of Children’s Kiva Montessori School.
Terms of Service