New Student Application 2021/2022

Student's Legal Name*
First Middle Last
Birthdate*
Month
Day
Year
Grade entering in fall of 2021*
Gender*
- Male
- Female
Home Address*
Street Address Address Line 2 City State ZIP Code
Residence School District*
Current School*
This application is for a child with ...mark only those that apply to this student ...(criteria for enrollment status in lottery)
Press and hold control to select multiple
Describe preference selected: sibling name, employee name, Founding Member name, Montessori School name
Parent Guardian Information
1. Parent Guardian Name*
First Last
Email*
Phone*
Other Phone
2. Parent Guardian Name
First Last
Email
Phone
Other Phone
RSMS does not discriminate on the basis of race, ethnicity, national origin, religion, gender, sexual orientation, home language, or disability (Education Code Section 47605(b)(5)(G).) RSMS does adhere to all provisions of federal law related to students with disabilities. If your child has an IEP or Section 504 Plan, it is the policy of RSMS to require a current IEP or 504 Plan to be submitted and on file in the school office upon enrollment.
Signature
I declare that the information provided on this application is truthful to the best of my knowledge.
Name
First Last
Date
MM slash DD slash YYYY

This application is for a child with ...mark only those that apply to this student ...(criteria for enrollment status in lottery)