2008-2009 STUDENT APPLICATION

 

Lake Mary Montessori Academy, Inc.

   3551 W. Lake Mary Blvd., Lake Mary, FL 32746

Ph: 407-324-2304         www.LMMA.net

       E-mail: LMMontessori@aol.com

      Heads of School: Sheila Linville M.A.T. & Scott Linville M.A.

Please check one

Half Day Pre-school Program:  (8:30-12:30) _____________or with Elementary Sibling _________ (8:15-12:30)

Full Day Pre-school & Kindergarten:  (8:30-2:30) ________ or with Elementary Sibling _________ (8:15-2:15)

Full Day Elementary: (8:15 – 2:15) _________

*New children ages 3 & 4: The first two weeks of school the Transition Program will be 8:30-10:30 a.m.

 

Date: _______________                                                                                    

 

Student profile

Applicant’s Name(s) __________________________________________________________________

                                     (Last)                                         (First)                                              (Middle)                       (Preferred)

 

                                  ___________________________________________________________________

                                       (Last)                                       (First)                                              (Middle)                      (Preferred)

 

 

                                  ___________________________________________________________________

                                      (Last)                                       (First)                                              (Middle)                      (Preferred)

 

Home Address________________________________________________________________________

                               (Street)                                         (City)                                                  (State)                                     (Zip Code)                        

Neighborhood__________________________________     Male____ Female____    Birth Date______________ 

 

 

FAMILY PROFILE

 

Marital Status of Parents:      Q Single    Q Married     Q  Separated      Q Divorced     Q  Widowed

Mother                                                                                     Father

 

Name (Dr./Mrs./Ms.)__________________________             Name (Dr./Mr.)______________________________

 

Home Address_______________________________              Home Address_______________________________

                                      If different from applicant’s                                                                                  If different from applicant’s

                                                                                                     __________________________________________

                               

Home Phone________________________________               Home Phone________________________________

 

Cell Phone__________________________________              Cell Phone_________________________________

 

E-Mail_____________________________________               E-Mail____________________________________

 

Work Phone_________________________________               Work Phone_______________________________

 

Occupation/Title_____________________________                Occupation/Title____________________________

 

Company Name______________________________               Company Name____________________________

 

 

 

 

 

 

 

 

 

 

FAMILY PROFILE

With whom does the child live? ___________________________________________________________

 

Who is financially responsible for the child? _________________________________________________

 

Applicant’s Siblings

                Name                                                   Age              Birth Date                                School Attending

_____________________________________________________________________________________

 

_____________________________________________________________________________________

 

COMMUNITY INVOLVMENT

Please note what organizations you are personally affiliated with or active in: _____________________________________________________________________________________

 

_____________________________________________________________________________________

 

TRANSITION PROGRAM

New children will transition into the primary classes with two and a half weeks of a schedule from

8:30-10:30 am.  This is to enable the younger children to have a shorter day and make the adjustment to school a happy and successful experience for both parent and child.

 

OFFICE INFORMATION

Child’s Physician’s Name/Address: _______________________________________________________

Physician’s Phone: _________________________________________

 

Person(s) to pick up your child and in case of illness or emergency, if parents can not be contacted:

 

1. __________________________________________________________________________________

        (Name)                                                                                   (Phone)                                        (Relationship)

2. __________________________________________________________________________________

        (Name)                                                                                  (Phone)                                         (Relationship)

 

Grandparents

Paternal:                                                                        Maternal:

_________________________________________     _________________________________________

Title             First Name(s)                Last Name(s)                Title              First Name(s)              Last Name(s)

 

____________________________________________       _____________________________________________

Street                                                                                       Street

 

____________________________________________        _____________________________________________

City                                     State                            Zip Code              City                        State                                     Zip Code

 

_________________________________________________         __________________________________________________

E-Mail                                                                                                 E-Mail

 

_________________________________________________         __________________________________________________

Driver’s License                             Social Security #                          Driver’s License                                     Social Security #

 

_________________________________________    __________________________________________

    Father’s Signature                                        Date                    Mother’s Signature                                          Date

 

At the family visit, there is a $25.00 Assessment and Application fee.  The Heads of School will talk with your family about your child’s acceptance.  The Enrollment Deposit of $300 will be due to reserve your child’s space for the upcoming academic year.  All fees are non-refundable.