Student Name *
Applying for:
Charter
School
Early Childhood South Campus
Early Childhood North Campus
Additional fees may be required to complete this process for Early Childhood programs. Please review
our Tuition and Payment Plans page first and then
contact the IVMS Charter office if you have
further questions.
Sibling Name (if already
attending IVMS)
Please select grade level from one campus only:
Must be age 5 by Sept 1 to start Kindergarten
South Campus
OR
North Campus
School Year *
Date of Birth *
Birth Place
Home Street Address *
Village, Town or City *
County*
State or Province *
Zip Code *
Phone Number *
Email Address *
IEP (Individual Education Plan) Required?
yes
no
If yes, please
specify:
Speech/Language
Specific Learning Disability
Gifted
Occupational Therapy
Other:
Previous Education:
If your child has previous Montessori experience, please describe in detail below:
Additional Comments:
Please tell us anything you think we may
need to know about your child or his/her previous school and educational
experiences

Mother's
Information Mother's Name
Occupation
Employer
Home Phone Number
Work Phone Number
Cellular Phone Number

Father's
Information
Father's Name
Occupation
Employer
Home Phone Number
Work Phone Number
Cellular Phone Number

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