Download - 2014-2015 Montessori at Flatiron Application
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APPLICATION CHECKLIST
Application for AdmissionComplete the Application for Admission and send it to the Admissions Office.
Application FeeSubmit your $125 application fee. Checks should be made payable toTHE MONTESSORI AT FLATIRON.
Teacher/Mentor Evaluation
Applicants who are currently attending an Early Childhood program shouldgive signed copies of Teacher/Mentor Evaluation form to the applicantscurrent teacher/mentor. Ask that they be sent directly to the AdmissionsOffice.
Parent/Guardian StatementComplete the Parent/Guardian Statement and send it to theAdmissions Office.
Letter of RecommendationApplicants who have no prior schooling should have someone who knowsyour child well, but who is not a family relation, send a letter ofrecommendation to the Admissions Office.
All materials can be mailed to:
The Montessori at Flatiron
Admissions Office
5 W. 22ndStreet
New York, NY 10010
Or emailed to:
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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 Primary Full Day(Limited Availability)
Citizenship____________________________________________________________________________________
Language Spoken at Home_________________________________________________________________
Birthplace/Country__________________________________________________________________________
Home Address______________________________________________________________________________
Telephone________________________________
Email______________________________________
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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______________________________
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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)__________________________________________________
_________________________________________________________________________________________________
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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 Mother Deceased g Mother RemarriedParents Separated g Father Deceased g Father Remarried
Applicant lives with__________________________________________________________________________
If parents divorced, name of person with legal custody__________________________________
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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
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Grandparents
Parent 1
Grandparents Names________________________________________________________________________________
Mailing Address______________________________________________________________________________________
Parent 2
Grandparents Names________________________________________________________________________________
Mailing Address______________________________________________________________________________________
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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 aVietnam Era veteran, disabled veteran or any other class protected by law in theadministration of educational policies, programs, or activities; admissions policies;scholarship and loan awards; athletic or other School-administered programs oremployment.
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 toeducation, 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
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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 becontingent upon the completeness and accuracy of these statements.
WAIVER OF ACCESS: All rights of access conferred by the Family Educational Rights andPrivacy Act of 1974 (P.L. 93-80) as amended, or otherwise, to all information and materialsof any kind received by Montessori at Flatiron from any source in connection with theapplication 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 theapplication process.2. Non-matriculated, waiting list, and rejected applicants and their families do not haveaccess to their files.3. Matriculated students and their parents do not have access to their files if they havesigned the above waiver.
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TEACHER/MENTOR EVALUATIONto be completed by current teacher/mentor
To the Teacher/Mentor,
The child whose name appears below has applied for admission to The Montessori atFlatiron. Your evaluation is vital to our process. Thank you for taking time to complete thisevaluation. Your reflections are an important part of the childs application.
All information you provide will be held in confidence and disclosed only to the AdmissionsCommittee.
Please complete both sides of this form, make a copy for your records and return to:
The Montessori at Flatiron
5 West 22ndStreet
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:
BelowOutstanding Excellent Good Average
Ability to reason ( ) ( ) ( ) ( )
Intellectual curiosity ( ) ( ) ( ) ( )
Desire for learning ( ) ( ) ( ) ( )gMotivation 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 ( ) ( ) ( ) ( )gPoliteness ( ) ( ) ( ) ( )g
Classroom/Group Behavior ( ) ( ) ( ) ( )
Reaction to Setbacks ( ) ( ) ( ) ( )
I recommend this applicant ( )Enthusiastically ( )Strongly ( )Without Reservationg
( )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 STATEMENTTo be completed by parent/guardian.
We are interested in parents thoughts about their child. We encourage you to write astatement 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 feelmay 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 RECOMMENDATIONTo 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 astatement describing his/her qualities and the nature of your relationship.
Full Name_____________________________________________________________________________________________First Middle Last
Signature___________________________________________________________________ Date_____________________