2021-2022 Children's Kiva Montessori Charter K-8 New Student Pre-Enrollment Form

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Completion and submission of this Enrollment Form does not guarantee nor quantify placement. This form is due by midnight on April 1, 2020. Placement confirmations will begin in May 2020.

Please submit one form per child you wish to enroll.

Email *

Child's Last Name *

Child's First Name *

Child's Date of Birth *

YYYY

Child's Gender

Female

Male

Undeclared

Clear selection

Child's Grade Placement *

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

7th Grade

8th Grade

First Contact Legal Guardian Name(s) (First and Last Name) *

Contact Phone Number for Guardian listed above

Second Contact-Legal Guardian Name (First Last Name)

Second Guardian Contact Phone Number

Mailing Address (Street Number, Street Name, City, Zip Code) *

Sibling Information. KM policy gives preferential placement to siblings of returning and admitted Kiva students. Should there be more siblings of returning and admitted Kiva students than enrollment openings for a given grade, enrollment shall be offered at the Head of School’s discretion. If a sibling is applying, you must submit an application for each child applying for 2021-22.

Acknowledged.

Sibling 1 Name

Sibling 1 Status

Currently Attending Kiva Montessori Charter School.

Applying to Kiva Montessori Charter School for 2021-22 School Year.

Sibling 2 Name

Sibling 2 Status

Currently Attending Kiva Montessori Charter School.

Applying to Kiva Montessori Charter School for 2021-22 School Year.

Current School District *

Montezuma-Cortez RE-1

Dolores RE-4a

Mancos RE-6

Dolores County RE-2J

Charter

Home School

Other

What is the primary language spoken at home? *

English

Spanish

Other

Is your student currently on an IEP, RTI or Behavior Plan? Note: Children's Kiva Montessori School does not discriminate based on any disability, gender, race, religion or individual need. This question is solely included to accommodate for transition planning including welcoming your child into our program. *

Yes

Do you currently qualify for Free and Reduced Price Meals? *

Yes

I have read, understand and agree to abide by the information contained herein. Please check each box as you agree. *

It is my responsibility to familiarize myself with Kiva Montessori's enrollment process; detailed information is provided on our website at kivacharter.org.

Kiva Montessori Charter School's "Guiding Principles"--found at kivacharter.org org--describe our whole child, whole school and whole community approach. To support our school, each family is asked to contribute a minimum of ten Family Partnership hours during the course of the year. By submitting this registration, you agree to engage in this positive community effort.

Upon notice of placement, I will be required to complete additional paperwork including but not limited to: providing proof of immunizations, proof of a well child check up signed by a physician, enrollment documents, etc.

Submission of this form Pre-Enrollment does not guarantee enrollment. Spaces are filled on a first come, first serve basis. In the event all spaces have filled, you will be contacted and placed on a wait list. Placement confirmation will be conducted in April 2021.

A non-refundable materials fee of $186 will be required prior to the first day of school. Scholarship funds and other financial assistance are available to those who qualify.

Required

I (We) have read and understand all information contained herein. By typing your name below you agree that the information I (we) have provided herein is accurate and can be used for Children's Kiva Montessori School purposes.

Send me a copy of my responses.

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