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Faith Application Form

This document is an application for admission to Faith Academy of Montessori. It requests information such as the child's name, birthdate, address, parents' contact information, as well as which days the child will attend and if they need extended care. It also includes authorizations for emergency medical care, field trips, and agreements between the director and parents regarding communication, illness policies, and discharge procedures.

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Alex Lysis Parson
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35 views3 pages

Faith Application Form

This document is an application for admission to Faith Academy of Montessori. It requests information such as the child's name, birthdate, address, parents' contact information, as well as which days the child will attend and if they need extended care. It also includes authorizations for emergency medical care, field trips, and agreements between the director and parents regarding communication, illness policies, and discharge procedures.

Uploaded by

Alex Lysis Parson
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Faith Academy of Montessori

Application for Admission Date___________ Name____________________Birth Date_____Sex___Age__ (Last) (First) (Middle)


Home Address_______________________________ ___________
(Street & number) (Zip) (Phone) (City and State)

Does child live with mother and father?____ ___________________


(If not, with whom?)

Days Requested: __M __T __W __Th __F care? ________

Extended

Fathers Name________________ Mothers Name_______________ Occupation__________________ Occupation__________________ Business____________________ Business___________________ Business Address______________ Business Address______________ Business Phone_______________ Business Phone ______________ Cell Phone__________________ Cell Phone___________________ Email Address:___________________________________________

If Not Available in Emergency Notify: 1.___________________________ Phone___________________ ____________________________ Relationship_______________


(Street & Number) City, State

2.__________________________ Phone____________________ ___________________________ Relationship________________


(Street & Number) City, State

Who other than parents or guardian is authorized to pick up your child? 1.___________________________Relationship_____________ ___ 2.___________________________Relationship_____________ __ 3.___________________________Relationship_____________ ___ __________________________ Parent/Guardian) AUTHORIZATION FOR EMERGENCY MEDICAL CARE
It is my understanding that I will be notified at once in case of accident or illness to my child, and that I will make arrangements for medical care of my child with the physician or hospital of my choice. However, if I cannot be reached to make the necessary arrangements, or in critical emergency requiring medical care, I hereby authorize: (name of school) To contact Dr. ___________________________________________________________

(Signature of

(Name)

(Address)

(Phone)

for emergency treatment of my child. My preferred hospital is: (Name) (Address) (Phone)

Field Trip Permission


I hereby give permission for my child _________________________________________ to attend field trips taken by Faith Academy of Montessori. It is my understanding that the adult/child ratio required by the State Licensing Department will be maintained by the staff during these trips. I also understand that I will be informed in advance of the dates and times of these trips. Occasionally the school may take walks around the area, and I give permission for these walks to be taken without prior notification.

Agreements
A) The director and I have agreed on a plan for continuing communication regarding my childs education, development, behavior, etc. B) When my child is ill it is understood and agreed that he/she will not be accepted into school. If he/she becomes ill during the day I have agreed to arrive promptly to take him/her home. C) I have been informed of this schools policies pertaining to the admission, education, care and discharge of children. D) I have been informed that a copy of the rules for Child Day Care centers in Missouri is available at the facility for review upon request. E) I agree to give thirty days written notice when my child leaves Faith Academy.

Parent/Guardian)

Date______________________ _ __________________________ (Signature of

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