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Gladwyne Montessori
920 Youngsford Road
Gladwyne, Pennsylvania 19035
Tel (610) 649-1761
Contact Us
Application for admission to Program:*
   
Parent/Toddler
Stepping Stones - 3 mornings; 9-11:15 a.m. Mon.-Wed.
Stepping Stones - 2 mornings - 9-11:15 a.m. Thur. and Fri.
Stepping Stones - 5 Full Days - 9-3 p.m. Mon.-Fri.
Primary Half Day (8:45-11:45 a.m.)
Primary Full Day (8:30 a.m. - 3 p.m. Mon.-Thur., 8:30-11:45 a.m. Fri.
Elementary Lower Level
Elementary Upper Level
For the academic year*
     
Applicant:
Applicant name (first, middle, last)*
     
Name child prefers
     
Sex*
   
Male
Female
Date of Birth*
     
Home Address*
       
City*
     
State*
     
Zip Code*
     
Telephone Number*
     
Email:*
     
School District:
     
Previous Schooling (If so, please briefly explain)
       
Does applicant have any medical/psychological conditions (temporary or permanent)? if so, please briefly explain:
       
Family Information:
Applicant currently lives with (select all that apply):*
   
Father
Mother
Stepfather
Stepmother
Check any that may apply:
   
Father is deceased
Mother is deceased
Parents are separated
Parents are divorced
Father has custody
Mother has custody
Joint custody
Name of person responsible for financial payment:*
     
Father's Name*
     
Full Address (if different from applicant)
       
Occupation*
     
Employer*
     
Business address:
       
Home Phone:
     
Work Phone
     
Cell Phone
     
Father's Email
     
Mother's Name*
     
Full Address (if different from applicant)
       
Occupation*
     
Employer*
     
Business address
       
Home Phone
     
Work Phone
     
Cell Phone:
     
Mother's Email
     
Address correspondence to (Mr. & Mrs., Drs. or other - as you would like listed in school directory)
     
Brothers and Sisters (Name, age, present school)
       
Relatives who have attended Gladwyne Montessori (name and relationship to student)
       
Maternal Grandparents Name(s)
       
Maternal Grandparents Address(es):
       
Paternal Grandparents Name(s)
       
Paternal Grandparent(s) Address(es)
       
Tell us how you heard about Gladwyne Montessori?
       

Signed
(Father/Guardian)*
     
(Mother/Guardian)*
     
You may submit and pay the $50 application fee by entering 50.00 in the field below*
     
Cardholder’s Name:
Credit Card Type:
Card Number:
Expiration Date:

Please Note: Questions marked with an asterisk (*) are required.




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