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ALIVE MONTESSORI & PRIVATE SCHOOL APPLICATION FOR ADMISSION
  • Date of Registration:*
  • New Enrollment?*select just one
  • A. Contact Information:
  • Legal Name of Child:*given names
  • Last Name*surname
  • Preferred Name:*
  • Sex:*select one or more
  • Child’s Birthday:*
  • Age:*
  • Grade:*
  • Mother’s Name:*
  • Father's Name:*
  • Cell Phone:*
  • Cell Phone:*
  • Home Phone:*
  • Home Phone:*
  • Email:*
  • Email:*
  • Work Phone:*
  • Work Phone:*
  • Employer:*
  • Employer:*
  • Address:*primary
  • Address:*secondary
  • Emergency contact (other than parent/guardian) in order of priority of contact:
  • Name:*
  • Relationship to Child:*
  • Phone Number:*
  • Name:*
  • Relationship to Child:*
  • Phone Number:*
  • Name:*
  • Relationship to Child:*
  • Phone Number:*
  • Person responsible for transportation (other than parent/guardian):
  • Name:*
  • Relationship to Child:*
  • Phone Number:*
  • Name:*
  • Relationship to Child:*
  • Phone Number:*
  • Name:*
  • Relationship to Child:*
  • Phone Number:*
  • B. Medical Information:
  • Child’s Name:*
  • Family Physician:*
  • Phone:*
  • Has your child been diagnosed with any disease? Please specify.*
  • Has your child been immunized?*
  • Name of Health Unit:*
  • Has your child’s vision been checked?*
  • Corrective lenses required?*
  • Has your child’s hearing been checked?*
  • Does your child sleep well?*
  • Has your child ever had any serious illness or accident? Please specify.*
  • If your child has eczema, asthma or allergies, please specify and describe reaction:*
  • If your child is receiving medication on an ongoing basis, please describe, including any potential side effects:*
  • Please describe your approach to ensuring your child is on a healthy diet, including limiting sugar.*
  • C. Documentation:
  • We are required by the Ontario Ministry of Education to keep copies of the following documents on file. Please supply original documents, which we will photocopy.
  • Documents*check all that you have
  • D. General Information:
  • Child’s Name:*
  • Language(s) spoken at home:*
  • Citizenship:*
  • If not a Canadian Citizen, type of visa and expiry date:*
  • Does your child have any behavior problems that you are aware of? Please describe, including any environmental or medical factors that may set these off.*
  • Please give a brief outline of your approach to discipline at home.*
  • E. Academic Information:
  • Previous School/Day Care:*
  • Phone:*
  • Address:*
  • Contact:*
  • Does your child need special attention with any of the following? Please describe any difficulties.*select one or more
  • Diffculties:*further details
  • By enrolling in Alive Montessori & Private School, what do you hope to achieve for you child?*