The Children�s House Montessori School by 2cTV183

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									                                              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__/__/___
                                                                                                                                  PCQBDS
                                                          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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