Admission Application | North Shore Montessori

Child Information

First Name *

Last Name *

Date of birth *

Sex *

Street Address *

City *

State *

Postal code *

General Questions

Child’s Previous School Experience

Child's Health

Child’s General Health

Child’s Medical Concerns, Handicaps, or Allergies

Medical Concerns

Handicaps

Allergies

Parent and/or Legal Guardian Information

First Parent/Legal Guardian

First Name *

Last Name *

Relationship to Child *

Street Address *

City *

State *

Postal Code *

Cell # *

Home # *

Work # *

Email *

Occupation *

Second Parent/Legal Guardian

First Name

Last Name

Relationship to Child

Street Address

City

State

Postal Code

Cell #

Home #

Work #

Email

Occupation

Emergency Contact

Name *

Phone # *

The North Shore Montessori School does not discriminate based on race, color, religion, national or ethnic origin, or family configuration.

Signatures of Parent or Legal Guardian (1) *

Clear

Date *

Signatures of Parent or Legal Guardian (2) *

Clear

Date *