The Children’s House Montessori School For Office Use 3404 Belmont Boulevard Fee______ __/__/____ Nashville, TN 37215 PV __/__/____ (615) 298-5647 fax (615) 385-3943 OHL _______ OH www.childrenshousenashville.org CS __/__/____ CRD__/__/___ PCQBDS Admission Application Today’s Date _______________________________ For Enrollment Beginning Fall, 20______ Enrollment Preference Full Time Part Time First Available Applicant’s Full Name Gender Goes by Date of birth Was this child born in the USA? Yes No OPTIONAL: African American Asian Caucasian Latino Native American Middle Eastern Multi-racial ESL (English is second language for either parent or child) Other Parent 1 Name (include prefix) Home Address City ST Zip Employer Occupation Home Phone Work Phone Cell Phone/Pager E-mail Parent 2 Name (include prefix) Home Address City ST Zip Employer Occupation Home Phone Work Phone Cell Phone/Pager E-mail Status of Parents: Married Separated Divorced Other Child is living with Both Parents Parent 1 Parent 2 Other Siblings Age School How did you hear about The Children’s House? Yellow Pages Nashville Parent Magazine Internet/Website Newspaper Ad Word of mouth from Other A nonrefundable application fee of $70.00 must be returned with this application. Signature of parent or guardian Date The Children’s House does not discriminate against anyone on the basis of race, color, gender, sexual orientation, age or national origin in administration of its educational policies, admissions policies, and other school-administered programs and makes every effort to promote diversity within its student body and staff and as a value in its curriculum. An application for need based tuition assistance is available, by request.
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