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APPLICATION CHECKLIST  Application for Admission Complete the Application for Admission and send it to

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 applicant’s 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. 22 nd Street New York, NY 10010

Or emailed to:

admissions@themontessori.org

at Flatiron Admissions Office 5 W. 22 nd Street New York, NY 10010 Or emailed to:
APPLICATION FOR ADMISSION for School Year 2014-15 To be completed by parent/guardian Applicant Information g

APPLICATION FOR ADMISSION for School Year 2014-15 To be completed by parent/guardian

Applicant Information g

Non-refundable application fee enclosed

Applicant’s Full Name

Preferred Name

Social Security No

Sex:

Male g

Date of Birth

Female

Age by September 1, 2014

Years

Expected Date of Entry

Program (circle one)

Toddler Half Day (Limited Availability)

Citizenship

Language Spoken at Home

Birthplace/Country

Months

Toddler Full Day

Primary Full Day

Home Address

Telephone

Email

Language Spoken at Home Birthplace/Country Months Toddler Full Day Primary Full Day Home Address Telephone Email
Names and Dates of Applicant’s Participation in Other Prog rams/Groups Does your child have learning

Names and Dates of Applicant’s 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

Relationship to Child

Social Security No

Home Address

Mailing Address (if different from home)

Middle

Last

Best way to contact: g Home Telephone g Work Telephone g Cell Phone g Email

Home Telephone

Home Fax

Business Telephone

Best way to contact: g Home Telephone g Work Telephone g Cell Phone g Email Home
Business Fax Cell Phone Cell Phone Carrier Email Occupation Employer Citizen of Primary Language

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

Relationship To Child

Social Security No

Home Address

Mailing Address (if different from home)

g Ms. First Relationship To Child Social Security No Home Address Mailing Address (if different from

Middle

Last

Best way to contact: g Home Telephone g Work Telephone g Cell Phone g Email

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 Parents Separated g

g

Applicant lives with

Mother Deceased g Father Deceased g

Mother Remarried Father Remarried

If parents divorced, name of person with legal custody

Deceased g Father Deceased g Mother Remarried Father Remarried If parents divorced, name of person with
Financial correspondence should be mailed to Copies of financial correspondence should be mailed to General

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

Relationship

Relatives or friends who attend The Montessori at Flatiron

Other children Name Date of Birth Current School Relationship Relatives or friends who attend The Montessori
Grandparents Parent 1 Grandparents’ Names Mailing Address Parent 2 Grandparents’ Names Mailing Address 7

Grandparents

Parent 1 Grandparents’ Names

Mailing Address

Parent 2 Grandparents’ Names

Mailing Address

Grandparents Parent 1 Grandparents’ Names Mailing Address Parent 2 Grandparents’ Names Mailing Address 7
Optional Information Montessori at Flatiron values diversity and seeks talented students, faculty and staff from

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

g Native American g

Asian/Pacific-Islander g

Caucasian g

Hispanic/Latino

Other

Due to the School’s 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

Other Financial Aid Applying for Financial Aid? Yes g No If yes, please apply online at
Disclaimer ( ) I declare that the information reported on the application is true and

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.

3. Matriculated students and their parents do not have access to their files if they have
TEACHER/MENTOR EVALUATION to be completed by current teacher/mentor To the Teacher/Mentor, The child whose name

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 child’s 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 22 nd Street New York, NY 10010

Applicant Information

Applicant’s Full Name

How long have you known the applicant?

What is your position?

Number of Children in class/group

Applicant’s Full Name How long have you known the applicant? What is your position? Number of
Academic Qualities - Please rate the applicant in the following areas: Outstanding Excellent Good Below

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

g

( ) Enthusiastically ( ) Strongly ( ) Without Reservation

( )With Reservation g( ) Not at all

Signature of Teacher/Mentor Print Name of Teacher/Mentor Email

g ( ) I would like to receive a Montessori at Flatiron information packet

Telephone

Name of Teacher/Mentor Email g ( ) I would like to receive a Montessori at Flatiron

Date

PARENT/GUARDIAN STATEMENT To be completed by parent/guardian. We are interested in parents’ thoughts abo ut

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

Date

Signature of Parent/Guardian 2

Date

please include with this form. Signature of Parent/Guardian Date Signature of Parent/Guardian 2 Date 12
LETTER OF RECOMMENDATION To be completed by someone who knows the applicant but who is

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

qualities and the nature of your relationship. Full Name   First Middle Last Signature Date 13