APPLICATION CHECKLIST

Application for Admission

Complete the Application for Admission and send it to the Admissions Office.
Application Fee
Submit your $125 application fee. Checks should be made payable to
THE MONTESSORI AT FLATIRON.
Teacher/Mentor Evaluation
Applicants who are currently attending an Early Childhood program should
give signed copies of Teacher/Mentor Evaluation form to the applicants
current teacher/mentor. Ask that they be sent directly to the Admissions
Office.
Parent/Guardian Statement
Complete the Parent/Guardian Statement and send it to the
Admissions Office.
Letter of Recommendation
Applicants who have no prior schooling should have someone who knows
your child well, but who is not a family relation, send a letter of
recommendation to the Admissions Office.

All materials can be mailed to:

The Montessori at Flatiron
Admissions Office
5 W. 22nd Street
New York, NY 10010
Or emailed to:
admissions@themontessori.org

APPLICATION FOR ADMISSION for School Year 2014-15

To be completed by parent/guardian
Applicant Information g

Non-refundable application fee enclosed ______

Applicants Full Name_______________________________________________________________________

Preferred Name______________________________________________________________________________
Social Security No._________________________
Sex:

Male g

Female

Date of Birth_________________________________________________________________________________
Age by September 1, 2014 __________ Years __________ Months
Expected Date of Entry______________________________________________________________________
Program (circle one) Toddler Half Day Toddler Full Day
(Limited Availability)

Primary Full Day

Citizenship____________________________________________________________________________________
Language Spoken at Home_________________________________________________________________
Birthplace/Country__________________________________________________________________________
Home Address______________________________________________________________________________
Telephone________________________________
Email______________________________________

Names and Dates of Applicants Participation in Other Programs/Groups

Does your child have learning needs? G

Yes g

No

If yes, please submit current copy of any testing such as an IEP/Psych Evaluation.
Parent/Guardian 1
Dr. g Mr. g Mrs. g Ms. _____________________________________________________________________
First
Middle
Last
Relationship to Child_______________________________
Social Security No.__________________________________
Home Address________________________________________________________________________________
_________________________________________________________________________________________________
Mailing Address (if different from home)__________________________________________________
_________________________________________________________________________________________________
Best way to contact: g Home Telephone g Work Telephone g Cell Phone g Email
Home Telephone ________________________________
Home Fax_________________________________________
Business Telephone______________________________

Business Fax______________________________________
Cell Phone_________________________ Cell Phone Carrier___________________________
Email_______________________________
Occupation ___________________________________________________________________________________
Employer_____________________________________________________________________________________
Citizen of ___________________________
Primary Language_________________
College(s) Attended__________________________________________________________________________
Firms, Institutions or Foundations served as Director or Trustee_______________________
_________________________________________________________________________________________________

Parent/Guardian 2
Dr. g Mr. g Mrs. g Ms. _____________________________________________________________________
First
Middle
Last
Relationship To Child______________________________
Social Security No.__________________________________
Home Address________________________________________________________________________________
_________________________________________________________________________________________________
Mailing Address (if different from home)__________________________________________________
_________________________________________________________________________________________________

Best way to contact: g Home Telephone g Work Telephone g Cell Phone g Email
Home Telephone ________________________________
Home Fax_________________________________________
Business Telephone______________________________
Business Fax______________________________________
Cell Phone_________________________

Cell Phone Carrier___________________________

Email_______________________________
Occupation ___________________________________________________________________________________
Employer_____________________________________________________________________________________
Citizen of ___________________________
Primary Language_________________
College(s) Attended__________________________________________________________________________
Firms, Institutions or Foundations served as Director or Trustee_______________________
_________________________________________________________________________________________________
Check all that apply:
Parents Divorced
g
Parents Separated g

Mother Deceased g
Father Deceased g

Mother Remarried
Father Remarried

Applicant lives with__________________________________________________________________________

If parents divorced, name of person with legal custody__________________________________

Financial correspondence should be mailed to____________________________________________

Copies of financial correspondence should be mailed to_________________________________
General correspondence should be mailed to_____________________________________________
Copies of general correspondence should be mailed to___________________________________
Other children
Name

Date of Birth

Current School

Relatives or friends who attend The Montessori at Flatiron

Relationship

Grandparents
Parent 1
Grandparents Names________________________________________________________________________________
Mailing Address______________________________________________________________________________________

Parent 2
Grandparents Names________________________________________________________________________________
Mailing Address______________________________________________________________________________________

Optional Information
Montessori at Flatiron values diversity and seeks talented students, faculty and staff from
diverse backgrounds. Montessori at Flatiron does not discriminate on the basis of race, sex,
sexual orientation, religion, color, national or ethnic origin, age, disability, or status as a
Vietnam Era veteran, disabled veteran or any other class protected by law in the
administration of educational policies, programs, or activities; admissions policies;
scholarship and loan awards; athletic or other School-administered programs or
employment.
If you wish to identify yourself as a member of one of the following groups listed below,
please check the appropriate box:
g African-American g

Asian/Pacific-Islander g

Hispanic/Latino

g Native American g

Caucasian g

Other

Due to the Schools mission to have a diverse student body, and our global approach to
education, we celebrate the religious diversity of our community.
If you are willing, please share your religious affiliation with us________________________
We are glad that you have applied to Montessori at Flatiron. Please indicate how you
learned about us. (Circle all that apply.)
Current or previous student

Neighbor g

Newspaper Ad/Article

Current or previous parent g

Friend g

Website g

Colleague g

Other

Financial Aid
Applying for Financial Aid?

Yes g

No

If yes, please apply online at www.tuitionaid.com

Disclaimer
( ) I declare that the information reported on the application is true and complete. I
understand that the continued enrollment of the applicant after admission will be
contingent upon the completeness and accuracy of these statements.
WAIVER OF ACCESS: All rights of access conferred by the Family Educational Rights and
Privacy Act of 1974 (P.L. 93-80) as amended, or otherwise, to all information and materials
of any kind received by Montessori at Flatiron from any source in connection with the
application for admission, including this form, are hereby waived.
Signature of Parent/Guardian 1_______________________________________ Date_______________
Signature of Parent/Guardian 2_______________________________________ Date_______________
Confidentiality: Our interpretation of the significant features of the Buckley Amendment:
1. Applicants and their families do not have access to their admissions files during the
application process.
2. Non-matriculated, waiting list, and rejected applicants and their families do not have
access to their files.
3. Matriculated students and their parents do not have access to their files if they have
signed the above waiver.

TEACHER/MENTOR EVALUATION
to be completed by current teacher/mentor
To the Teacher/Mentor,
The child whose name appears below has applied for admission to The Montessori at
Flatiron. Your evaluation is vital to our process. Thank you for taking time to complete this
evaluation. Your reflections are an important part of the childs application.
All information you provide will be held in confidence and disclosed only to the Admissions
Committee.
Please complete both sides of this form, make a copy for your records and return to:
The Montessori at Flatiron
5 West 22nd Street
New York, NY 10010
Applicant Information
Applicants Full Name_______________________________________________________________________
How long have you known the applicant?_________________________________________________
What is your position?_______________________________________________________________________
Number of Children in class/group____________________________

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Academic Qualities - Please rate the applicant in the following areas:

Outstanding

Excellent

Good

Below
Average

Ability to reason

()

()

()

()

Intellectual curiosity

()

()

()

()

Desire for learning

g
Motivation and effort

()

()

()

()

()

()

()

( )g

Oral expression

()

()

()

()

Initiative g

()

()

()

()

Personal Qualities - Please rate the applicant in the following areas:

Outstanding

Excellent

Good

Average

Maturity

()

()

()

()

Participation in Activities

()

()

()

()

Consideration of Others
g
Politeness

()

()

()

()

()

()

()

( )g

Classroom/Group Behavior ( )

()

()

()

Reaction to Setbacks

()

()

()

()

I recommend this applicant ( ) Enthusiastically ( ) Strongly ( ) Without Reservation

g
( )With Reservation g( ) Not at all
Signature of Teacher/Mentor_________________________________________________ Date________________
Print Name of Teacher/Mentor_____________________________________________________________________
Email ______________________________________________ Telephone ______________________________________
g ( ) I would like to receive a Montessori at Flatiron information packet

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PARENT/GUARDIAN STATEMENT
To be completed by parent/guardian.
We are interested in parents thoughts about their child. We encourage you to write a
statement about your son or daughter describing his/her qualities and what his or her
needs are.
Feel free to attach additional pages if necessary. If there is other information that you feel
may help inform the admission committee please include with this form.

Signature of Parent/Guardian 1_ ___________________________________________Date__________

Signature of Parent/Guardian 2____________________________________________ Date__________

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LETTER OF RECOMMENDATION
To be completed by someone who knows the applicant but who is not a family relation.
We are interested in your thoughts about the applicant. We encourage you to write a
statement describing his/her qualities and the nature of your relationship.

Full Name_____________________________________________________________________________________________
First
Middle
Last
Signature___________________________________________________________________ Date_____________________

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