Registration Application CompanyThis field is for validation purposes and should be left unchanged.Child's NameSelect Boy Girl Date of Birth MM slash DD slash YYYY Preferred Starting Date MM slash DD slash YYYY Age at Starting DateSelect Classroom Lower Classroom: 3 - 4 Years of Age Upper Classroom: 4 - 5 Years of Age Mother's NameFather's NamePlace of EmploymentPlace of EmploymentWork PhoneWork PhoneCellCellEmail Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Preferred email for communication between you and the centerAs the date of these application, is your child toilet-trained? Yes No Has your child any allergies? Yes No If yes which type of allergy.?Is there any legal issue regarding the custody of the child ? Yes No If yes, who is responsible for the custody of the child?Has your child had previous childcare experience? Yes No If yes, for how long and where?How did you hear about Montessori Mes Petits? Friends, Internet,etcLanguage/s spoken at homeAttending DaysHow many days would you prefer? 2 3 5 Which days? Monday Tuesday Wednesday Thursday Friday Care and Education Fees: Children Below 3 Years of Age: Before Fee Reduction: 2 Days: $1,078; 3 Days: $1,340; 5 Days: $1,765. After Fee Reduction: 2 Days: $718; 3 Days: $800; 5 Days: $865. Children 3–5 and IF Potty Trained: Before Fee Reduction: 2 Days: $950; 3 Days: $1,262; 5 Days: $1,616. After Fee Reduction: 2 Days: $732; 3 Days: $935; 5 Days: $1,071. Children 3–5 and IF NOT Potty Trained: Before Fee Reduction: 2 Days: $950; 3 Days: $1,262; 5 Days: $1,616. After Fee Reduction: 2 Days: $757; 3 Days: $985; 5 Days: $1,171. Registration Fee: $150 non-refundable fee paid at the time of presenting this Registration. Security Deposit: $300 Upon Registration. Refundable with 1 Calendar month given notice of withdrawal. NOTES: If you choose to forego space, the Security Deposit will be returned only if one calendar month notice is given. A child may be accepted at the age of 30 months. Only two children between 30 and 36 months can be attending at the time in each classroom. If there are already two children between these months in the Lower Classroom, two children of the same age can be accepted into the Upper Classroom until they become 3 years of age. When they become 3 they may stay in the Upper Classroom if there is no space in the Lower Classroom. The second sibling will have a discount of 5% if both children are attending the center at the same time. Fees may change every year in September. Parent or GuardianDate MM slash DD slash YYYY
