Enrollment Form

Jewish Owl Montessori Childcare

Enrollment Form

Application Date:

Desired start date:

Childs name:

DOB:

Primary Language:

E-mail:

Emergency contact:

Phone:

Second Emergency contact:

Fathers name:

Home phone:

Home address:

Occupation:

Mothers name:
Home address:

M/F_

Home phone:

Cell phone:

Cell phone:

Occupation:

Where did you hear about Jewish Owl Montessori?

I give JOM permission to use my childs image for promotional material

I am interested in summer programs at JOM
I am interested in before/after care

6215 Lone Oak Dr. Bethesda, MD 20817/

(240)507-9897/

Jewishowl.com

Enrollment Form

Jewish Owl Montessori Childcare

Class Offering/ Tuition Fees

TUITION PAYMENTS ARE DUE THE FIRST DAY OF EACH MONTH. Cash/check

Please circle first choice

(Please notice that due to the limited capacity the fee cannot vary)

Mornings

8:00 am- 12:30 pm

MON TUE WED THU FRI

Extended Day

8:00 am- 3:30 pm

MON TUE WED THU FRI

3-4 days a week

Extended Day Program alternate days
Alternate days morning only

$650.00/month
$550.00/ month

5 days a week
Extended Day Program
Morning program only

$750.00/month
$650.00/month

Please check if interested in:

Before care from 7:00 am- 8:00 am
After care from 3:30 pm-6:00 pm

Available/MON-FRI $5.00 per day

Available/ MON-THU $15.00 per day /$240 per month

We hereby apply to Jewish Owl Montessori Child care for the program(s) stated on this application for the 20
school year or for the beginning date of
/_
/_
.

-20

Accompanying this application is the enrollment fee of $50.00 along with month tuition. I understand that in order
to hold my spot the second of tuition is due by
.
I understand that these payments are non-refundable.
We have read the Enrollment and Payment Policies (attached) and understand and agree to the terms.
Signature of Mother/Parent/Guardian
Date

Signature of Father/Parent/Guardian
Date
Please drop off or send completed form and application fee to:
Jewish Owl Montessori Childcare
6215 Lone Oak Dr.
Bethesda, MD 20817

Jewish Owl Montessori Childcare does not discriminate against students of any race, gender, color, national or ethnic
origin to the rights, privileges, programs and activities available at our school.

6215 Lone Oak Dr. Bethesda, MD 20817/

(240)507-9897/

Jewishowl.com

Enrollment Form

Jewish Owl Montessori Childcare

Applicant History

Describe briefly the childs temperament and personality.

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What kind of activities does the child enjoy?
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How does the child get along with adults?
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How does the child get along with peers?

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Describe briefly your childs language development.

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What language is/are spoken in the home?

Does your child have any allergies? If yes, please explain.

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Parents signature _______________________ Date __________________________

6215 Lone Oak Dr. Bethesda, MD 20817/

(240)507-9897/

Jewishowl.com