For the school year ________________to________________     

Date of Birth: Month__________Day________Year_________

Age of child on the first day of school ________years________months     
Male Female

Name of Child________________________________________________________

(Print all information, Last Name, First Name, Middle Name)

Mother's Name:___________________________Occupation___________________

Father's Name:____________________________Occupation___________________

Address:_____________________________________________________________

____________________________________________________________________

Telephone Information:

Mother/Home___________________Cell_______________Work________________

Father/Home___________________Cell_______________Work________________

E-mail Address:

Home______________________________Work_____________________________

Are you a pledging member of St. Christopher's Church?      Yes      No
Does your child have any prior Montessori Training?              Yes      No

If yes, name of school __________________________________________________

Do you have any other children currently enrolled, or who are alumni of St. Christopher's?   Yes      No

Name of Student:

____________________________________________________________________
Sibling Alumni

While completing this form will put your child on the waiting list for the coming school year (or when the child comes of age) IT DOES NOT GUARANTEE A SPACE FOR YOUR CHILD AT ANY TIME. St. Christopher's opens registration for the coming school year to returning students, their siblings and pledging church members BEFORE utilizing the waiting list.

Your child's name will be placed on the waiting list the day that the pre-registration fee is received ($50.00 non-refundable). Without this fee your application will not be processed.

I have read and completed the above form and I understand my application will not be processed without the $50.00 fee, nor is space guaranteed for my child at this time.

Name of parent or guardian: (please print)

____________________________________________________________________

Signature of parent or guardian:

____________________________________________________________________

Date_____________________________________

Payment Date ______________________Check Number ______________________

St. Christopher's Montessori School is in compliance with the Civil Rights laws of the United States and the State of Florida. We accommodate persons of all races, creeds and national origins and do not discriminate on the basis of race, religion, sex or national origin.