WMS ELEMENTARY PROGRAM APPLICATION FORM

Westside Montessori School Society

Elementary Program

Student Application Form

STUDENT INFORMATION

Child's Legal Name *

First Name Last Name

Child's Middle Name(s)

Preferred Name

Gender *

Male Female

Birth Date *

Month Day Year

Upload a current photo of your child.

Check all that apply. *

Canadian Citizen Aboriginal Ancestry Landed Immigrant Permanent Residency Other

If other, please provide details:

Applying for *

Current School Year Upcoming School Year

Please Note: We are able to enrol a limited number of International students who are not Canadian citizens or landed immigrants. Students must live with at least one of their parents during their stay. Fees are $17,000 per year and are non-refundable. Students must possess a valid student visa and are expected to attend through to the end of the school year.

Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Home Phone Number *

Phone Number

Student lives with: *

Mother Father Step Mother Step Father Guardian

Name(s) of Step Parent(s) Guardian(s)

Primary Language Spoken at Home *

Other Languages

EDUCATION HISTORY

Has your child had any previous school experience? *

Yes No

Forward copies of Progress Reports from the last two years to: admin@westsidemontessori.ca.

These are required to compelte your application.

Name of Current School: *

Location *

City, Province/State, Country

Dates Attended: *

Reason for Leaving: *

Has the applicant ever had any psychological or educational testing/evaluation? *

No Yes

If yes, please provide details and include a copy with your application.

Does the applicant currently receive any Education or Behaviour Support? *

Yes. Support is required. No

If yes, please describe:

Has the applicant ever required an Individual Education Plan (IEP)? *

Yes No

If yes, please provide details and include a copy with your application.

Were there any issues in your child's pervious school experience that we should be aware of? *

Yes No

If yes, please describe:

FAMILY INFORMATION

PARENT / GUARDIAN 1

Title *

Ms. Mrs. Mr. Dr.

Title *

Legal Name *

First Name Last Name

Preferred Name *

Check all that apply. *

Canadian Citizen Aboriginal Ancestry Landed Immigrant Permanent Residency Other

If other, please provide details:

Relationship to Student *

Resides with Student *

Yes No

E-mail *

Cell Phone Number *

Area Code Phone Number

Work Phone Number

Area Code Phone Number

Occupation *

Place of Work *

PARENT / GUARDIAN 2

Title

Ms. Mrs. Mr. Dr.

Legal Name

First Name Last Name

Preferred Name

Relationship to Student

Check all that apply.

Canadian Citizen Aboriginal Ancestry Landed Immigrant Permanent Residency Other

If other, please provide details:

Relationship to Student

Resides With Student

Yes No

Address (only if different than child)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Email

Cell Phone Number

Area Code Phone Number

Work Phone Number

Area Code Phone Number

Occupation

Place of Work

SIBLING INFORMATION

Does the applicant have any siblings? *

Yes No

Sibling 1: Full Name

First Name Last Name

Gender

Male Female

Birth Date

Month Day Year

School (if applicable)

Sibling 2: Full Name

First Name Last Name

Gender

Male Female

Birth Date

Month Day Year

School (if applicable)

Sibling 3: Full Name

First Name Last Name

Gender

Male Female

Birth Date

Month Day Year

School (if applicable)

STUDENT HEALTH INFORMATION

Are there any health, physical or emotional needs that we should be aware of? *

Yes No

Are there any health, physical or emotional needs that we should be aware of? *

Yes No

If yes, please provide details and include a copy with your application.

Does you child have any severe allergies requiring an EPI Pen? *

Yes No

If yes, please describe:

Are there any other allergies, food sensitivities and/or dietary restrictions that we should be aware of? *

Yes No

If yes, please elaborate.

ADDITIONAL INFORMATION

What is your understanding of Montessori education?

What are your child's interests and activities?

What do you consider to be your child’s strongest aptitudes and character traits?

What are your goals for your child in his or her elementary years?

Please include any other information you would like us to know about your child.

Who can we thank for referring you to our program? Please name if applicable.

Choose one: *

It is my intention to complete the Elementary Program at WMS through to Seventh Grade It is not my intention to complete the Elementary Program at WMS.

Comment:

I understand that:

1. This is merely an Application for Admission; no acceptance for enrollment is implied.

2. Enrollment shall be at the sole discretion of Westside Montessori School Society.

3. Once enrolled, children are expected to attend a full academic year, September through June.

4. The information on this form is collected under the authority of the School Act. Information is used for Ministry of Education reporting: demographic, enrolment, budget, facility, transportational and operational analyses. It will be kept secure and confidential, in accordance with the Freedom of Information and Protection of Privacy Act.

“I certify that the information I have provided on this form is correct.”

Signature *

Non-Refundable Application Fee

Application Fee $ 50.00 CAD

Total $ 0.00 CAD