Enrollment Application

Please fill out the form below to submit your child’s application.

 
Child Information
Student Name *
Student Name
Student DOB *
Student DOB
Gender *
Address *
Address
Phone *
Phone
Program Type: *
Please select which program you would like to enroll your child in. Children must be toilet-trained in order to be placed in the Primary Program.
Additional Care Options
Before care options are available for children enrolled in a program.
What is your child's primary language?
Capability *
Child is able to:
Areas of Concern
Please select any of the areas where your child requires additional assistance:
Feel free to include interests and strengths
Please include any medications/allergies
Parent or Legal Guardian Information #1
Name of Parent/Legal Guardian #1 *
Name of Parent/Legal Guardian #1
Phone of Parent/Legal Guardian #1 *
Phone of Parent/Legal Guardian #1
Address of Parent/Legal Guardian #1 *
Address of Parent/Legal Guardian #1
Parent or Legal Guardian Information #2
Name of Parent/Legal Guardian #2 *
Name of Parent/Legal Guardian #2
Phone of Parent/Legal Guardian #2 *
Phone of Parent/Legal Guardian #2
Address of Parent/Legal Guardian #2 *
Address of Parent/Legal Guardian #2
Parents/Guardians are *
Person responsible for tuition *
Person responsible for tuition
Billing Address
Billing Address
Please list individuals permitted to pick-up your child
Please list individuals NOT Permitted to pick-up your child. Appropriate paperwork such as custody papers shall be attached if a parent is not allowed to pick up the child.
Emergency Contact Information
Two people to contact in case the parents/legal guardians cannot be reached. Must live in VA, DC, or MD)
Emergency Contact #1
Name of Emergency Contact #1 *
Name of Emergency Contact #1
Phone of Emergency Contact #1 *
Phone of Emergency Contact #1
Emergency Contact #2
Name of Emergency Contact #2
Name of Emergency Contact #2
Phone of Emergency Contact #2 *
Phone of Emergency Contact #2
Admissions Procedure
1. Tour the School: We encourage every family to tour the school before submitting an application. Call 571-336-2559 or email info@lomamontessori.com to schedule a tour. The tour is an opportune time to ask questions and learn about our school. 2. Application: Complete and return the application with the $75.00 non-refundable application fee. Applications may be completed online, e-mailed to info@lomamontessori.com, or mailed to: Little Oaks Montessori Academy Attn: Admissions Committee 13525 Dulles Technology Drive, 103 Herndon, VA 20171 3. Acceptance Notification: Enrollment is on a rolling basis. Little Oaks Montessori Academy staff will notify you of the admission decision within 2 weeks of receiving a complete application. If Little Oaks Montessori Academy is full, your student may be placed on the waitlist. 4. Secure Enrollment: We hold a student’s position for 2 weeks. Please return the Registration Package and a $500 tuition deposit. The $500 deposit will be applied toward the last month of attendance. If you need longer than 2 weeks to make your decision, please contact the Admissions Committee at info@lomamontessori.com AGREEMENTS • The school agrees to notify the parent(s)/guardian(s) whenever the child becomes ill and the parent(s)/guardian(s) will have to arrange to have the child picked up as soon as possible if so requested by the school. • The parent(s)/guardian(s) authorize the school to obtain immediate medical care if any emergency occurs when the parent(s)/guardian(s) cannot be located immediately.(if there is an objection to seeking emergency medical care, a statement should be obtained from the parent(s)/guardian(s) that states the objection and reason for the objection.) • The parent(s)/guardian(s) agree to inform the school within 24 hours or the next business day after the child or any member of the immediate household has developed a reportable communicable disease, as defined by the state board of health, except for life threatening diseases which must be reported immediately. Little Oaks Montessori Academy does not discriminate based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age or family/parental status. Little Oaks Montessori Academy does not provide psychological services.