Reach Montessori Preschool
2490 Story Rd. San Jose CA 95122
(408)272-8888
Enrollment Application
Child’s Name: ______________________________________________________________
First Middle Last
Date of Birth: ____________________________________ Please Circle (Boy) or (GIRL)
Home Address: _________________________________________________________
Home Phone Number: ________________
Special Considerations: ___________________________________________________________
PLEASE SELECT A PROGRAM:
Infant Program ( ) 8:00-6:00pm M-F, M W F, T Tu( ) 8:00-12:00pm ( )12:00-5:00pm
Preschool-2 ( ) 8:00-6:00pm M-F, M W F, T Tu( ) 8:00-12:00pm ( )3:00-6:00pm
Preschool-3 Kindergarten ( )8:00-6:00pm M-F, M W F, T Tu( ) 8:00-12:00pm( )3pm-6:00pm
Program: ____________________Potty Training need ( ) yes ( )no
| Father’s Name: ______________________________ Cell Phone: ________________________Employer Name: _____________________________ Work Phone: _______________________
Business Address_____________________________ Email: ____________________________ Social Security # _____________________________ Drivers License: ______________________ Does Father live with the child? ( ) Yes ( ) No Mother’s Name: _____________________________Cell Phone: _________________________ Employer Name: _____________________________Work Phone: ________________________ Business Address_____________________________Email: _____________________________ Social Security # _____________________________ Drivers License: ______________________ Does Mother live with the child? ( ) Yes ( ) No |
All enrollment applications are subject to approval and space is not guaranteed until a registration fee has been paid and the enrollment application has been signed.
I/We have received the Parent Handbook ______________Parent Initial
Parent 1 Signature_______________________________Date___________________________
Parent 2 signature___________________________ Date___________________________
| For Office Use: Starting Date: _____________ Classroom_______Registration Fee $__________ CK #________ CK Date_______ |