Application for Admission

Montessori International Children’s House

Student Information

Student First Name *

Student Last Name *

Prefer to be Called

Student Address *

Student Date of birth *

Student Sex

Male

Female

Student Home Phone Number *

Student Citizenship

Student Birthplace

Student Racial or Ethnic Group (Optional, this information is kept confidential. Leaving this item blank will not adversely effect your application.)

American Indian/Alaskan

Asian/Pacific Islander

Hispanic

Black, non-Hispanic

White, non-Hispanic

Primary Language Spoken at Home

Applicant’s Second Language

Applicant’s parents are

Married

Divorced

Separated

Remarried

Single

Widowed

Applicant lives with

Biological Parents
Parent & Step Parent
Single Parent
Adoptive Parents
Guardian
Grandparents
Other (please specify)
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Other

Who has legal custody of applicant? *

School (including Pre-school and Day Care) Currently Attending

Address of School

Other Schools/Programs Applicant has attended (please include name, city and state, and dates of attendance)

Applicant’s Siblings (in order of birth)

Include: Name, age, M/F, current school, also applying to MICH?

Are there any pertinent medical, psychological or emotional issues that may require special attention or limit participation in school activities?

Family Information

Parent 1

Parent 1 Full Name *

Parent 1 *

Mrs

Relationship to Applicant *

Home Street Address *

City *

State *

Zip code

Home Phone #

Cell Phone # *

Email *

Employer

Position/Title

Occupation

Work Address

Business Phone #

Colleges Attended

Parent 2

Parent 2 Full Name

Parent 2

Mrs

Relationship to Applicant

Home Street Address

City

State

Zip code

Home Phone #

Cell Phone #

Employer

Position/Title

Occupation

Work Address

Business Phone #

Colleges Attended

Person to whom admission correspondence should be sent

Person who is financially responsible for tuition

Have you applied to MICH for another child? Please indicate child’s name and when application was made.

How did you learn about MICH?

Please list any relatives or friends who have attended MICH.

Name, When attended and Relationship

Are you applying to any other schools? If so, please list them.

Why are you considering a Montessori education for your child?

What do you hope your child learns by the time of his/her graduation from MICH?

Help us get to know your child:

What 3 words best describe your child?

What does your child enjoy doing?

What family activities does he/she enjoy the most?

Please let us know if your child has participated in any type of organized activity.

Use the following space to make any comments that might help us better understand your child. Include any factors of your child’s personality which make him or her unique.

Application and Fee Completion Notice

To proceed with the admission process, please ensure the following:

The application form is fully completed.
The application fee has been paid.

Pay Application Fee Here

I confirm that I have completed the payment of the application fee.

Yes

I certify that the information in this application is true, accurate, and complete. I authorize Montessori International Children’s House to request any information that it believes is relevant to this application process. I understand that false, incomplete, omitted or misleading information given in this application or during the application process may result in a refusal to admit or dismissal in the event of admission.

On behalf of the applicant, I hereby make application to Montessori International Children’s House.

MICH admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. MICH does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, and other school-administered programs.

Date

Parent Signature

Clear

I agree to this privacy policy. By providing my phone number, I agree to receive text messages from Montessori International Children's House.