Bay Montessori School
20525 Willows Road
Lexington Park, Md. 20653

Or Fax to: 301-737-2837

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BAY MONTESSORI SCHOOL APPLICATION FORM

Session Desired: __ Morning(Montessori) __ Extended Day
__ Full Day(Montessori) __ Summer Program
__ Elementary(Montessori)

Arrival Time: _____________________ Departure Time: _____________________

Date you would like your child to start: ________________________________

Child¹s Name: ___________________________________________________________

Nickname: _________________ Date of Birth: ________________ Sex: ________

Home Phone: (___) ___-____ E-mail: ______________________________________

Home Address: ___________________________________________________________

City: _____________________________________ State: _____ Zip: ___________

Mother's Name: _______________________ Occupation: ______________________

Business Address: _________________________________ Phone: (___) ___-____

Father's Name: _______________________ Occupation: ______________________

Business Address: _________________________________ Phone: (___) ___-____

Name of health insurance co: _______________________ Policy#: ___________

Names, ages and sex of other children in the family:

Is your child toilet trained: Yes No (circle one)

How many hours a week does your child watch TV: ___________

Has your child attended school previously, where and for how long:

What kind of things do you enjoy doing with your child:

Why do you wish to send your child to a Montessori school:

How did you first hear about Bay Montessori School:

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Please print this page and mail to:

Or fax to: 301-737-2837 Bay Montessori School
20525 Willows Road
Lexington Park, Md. 20653

The School has my permission to photograph my child for school purposes.

Parent signature____________________________