Enrollment

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:

Toddler Program (   ) 8:00-6:00pm M-F, M W F, T Tu(   ) 8:00-12:00pm (   )12:30-6:00pm

Preschool Program (   ) 8:00-6:00pm M-F, M W F, T Tu(   ) 8:00-12:00pm (   )12:30-6:00pm

Kindergarten Program(   ) 8:00-6:00pm M-F, M W F, T Tu(   ) 8:00-12:00pm (   )12:30-6:00pm 

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_______