1403 Regency Drive East, Savoy, IL
61874
(217) 356-1818
info@montessorischoolofcu.org
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MSCU Application for Enrollment 2021-22
We are delighted that you are considering applying to our school. Please fill out a separate application for each child in your family. Thank you for your interest in the Montessori School of Champaign-Urbana!
Step 1 of 7 - Application Type
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Choose the option that best describes your situation:
*
My child is a current MSCU student re-enrolling for next year.
My child and family are completely new to MSCU.
My child is not at MSCU yet, but currently has a sibling enrolled here.
We are a returning family who do not currently have any children enrolled at MSCU.
Please indicate any information you may need to update in our records.
*
NO CHANGES FROM THIS YEAR'S INFORMATION
Need to update my child's diet and/or allergy information
Need to update parent/guardian contact information
Need to update emergency contact information
Need to update permissions
Application Fee Cost
There is a one-time, $50.00 family application fee to have this application processed. You will have a chance to choose your method of payment at the end of the application. If you choose to pay online, $1.80 in processing fees apply, for a total charge of $51.80.
Price:
$51.80
How many children do you hope to enroll (concurrently) at this time?
*
(Please fill out a separate online enrollment form for each child.)
1
More than 1
Student Information
Student Name
*
First
Last
Birthdate
*
Date Format: MM slash DD slash YYYY
Child's Birthplace
*
Gender
*
Male
Female
Which morning room is your child currently in?
*
Bird
Teddy Bear
Bunny
Duck
Horse
Kitty
Puppy
Lower Elementary
Upper Elementary
Please choose the diet that best suits your child's needs:
*
(Please note, we do NOT serve pork or seafood. ALL meals include whole grains and vegetables/fruit.)
Regular diet (includes meat, egg, dairy)
White Meat Only (includes poultry, egg, dairy)
Vegetarian (no meat; includes meat substitutes, egg, dairy)
Vegan (no animal products; includes appropriate meat substitutes)
Dairy-Free (includes meat and egg)
Gluten-Free (includes gluten-free whole grains, meat, egg, and dairy)
Does your child have any allergies or health/medical concerns we should know of?
*
Yes, my child has allergies/health/medical concerns
No, my child has no allergies or health/medical concerns.
Does your child have an Epi-Pen?
*
Yes
No
Please describe any allergies, health, or medical concerns relevant to your child.
*
For allergies, please describe the level of severity of each allergy (e.g., anaphylactic reaction, etc.).
Program Information
Which school year are you applying for?
*
2021-22
2022-23
2023-24
2024-25
2025-26
Which program are you applying for?
*
Toddler (18-36 months old)
Pre-K (3-6 years old, not in Kindergarten)
Kindergarten (5-6 years old, entering kindergarten)
Elementary (Grades 1-6)
Secondary (Grade 7)
What Elementary or Secondary year will your child be entering?
*
(If you are not sure, please enter the grade level they would be entering BASED ON AGE ONLY if they were in public school.)
1
2
3
4
5
6
7
When do you hope to have your child start at MSCU?
*
Please enter a month and year (e.g. "August 2021"), or a specific date if you know it (e.g., "September 7, 2021"). Enter "August 2021" if you want to start at the beginning of the 2021-22 school year.
What start time do you need each day for this child?
*
8:30AM (no additional cost)
What pickup time do you need each day for this child?
*
2:30PM (TODDLER/PRIMARY ONLY - No additional cost)
3:00PM (ELEMENTARY OR SECONDARY ONLY- No additional cost)
5:30PM (PRIMARY/ELEMENTARY/SECONDARY ONLY, additional cost for Afterschool Care applies)
Does your child need a nap?
*
Yes
No
Family Information
Parent/Guardian 1 Name
*
First
Last
Relationship to Child
*
Mother
Father
Other Guardian
Workplace
Contact Phone
*
Contact Email
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Does the child live with this parent/guardian?
*
Yes, full-time
Yes, part-time
No
Add another parent/guardian?
*
Yes
No
Parent/Guardian 2 Name
*
First
Last
Relationship to Child
*
Mother
Father
Other Guardian
Workplace
Contact Phone
*
Contact Email
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Is this parent/guardian's address the same as the first?
*
Yes
No
Does the child live with this parent/guardian?
*
Yes, full-time
Yes, part-time
No
Emergency Contact 1
*
First
Last
Relationship to Child
Phone
*
Do you want us to contact this person in case of emergency?
*
Yes
No
Is this person allowed to pick up your child from school?
*
Yes
No
Add another emergency contact?
*
Yes
No
Emergency Contact 2
*
First
Last
Relationship to Child
Phone
*
Do you want us to contact this person in case of emergency?
*
Yes
No
Is this person allowed to pick up your child from school?
*
Yes
No
Add another emergency contact?
*
Yes
No
Emergency Contact 3
*
First
Last
Relationship to Child
Phone
*
Do you want us to contact this person in case of emergency?
*
Yes
No
Is this person allowed to pick up your child from school?
*
Yes
No
Add another emergency contact?
*
Yes
No
Emergency Contact 4
*
First
Last
Relationship to Child
Phone
*
Do you want us to contact this person in case of emergency?
*
Yes
No
Is this person allowed to pick up your child from school?
*
Yes
No
Add another emergency contact?
*
Yes
No
Emergency Contact 5
*
First
Last
Relationship to Child
Phone
*
Do you want us to contact this person in case of emergency?
*
Yes
No
Is this person allowed to pick up your child from school?
*
Yes
No
Child's Race
This is for the "Non-Public Registration, Enrollment, & Staff Report" which MSCU must submit to the State of Illinois annually.
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Two or More Races
Home Language Survey
Information related to languages spoken in the home is solely used to help assess the school's eligibility for state funding through the local LEA for English learner support. We do NOT use this information to determine class placement or any other enrollment decisions.
Is a language other than English spoken in your home?
*
Yes
No
Which language(s) other than English is/are spoken in your home?
*
Does your child speak a language other than English?
*
Yes
No
Which language(s) other than English is/are spoken by your child?
*
Current School
Where does your child currently attend school?
(If you homeschool or your child is not currently at a school, please write "Home")
How did you hear about MSCU?
From another MSCU family
Internet search
Newspaper
Social media
Advertisement/Billboard
Permissions
In case of sickness or accident, I hereby give consent to the Montessori School of Champaign-Urbana to provide emergency care through a clinic, a hospital, or a private doctor for my child.
*
Yes
No
I hereby give consent for my child to attend ALL field trips. Pre-K and Elementary age children will be transported by bus.
*
(Toddler children will not take field trips.)
Yes
No
In case of MINOR accidents, I hereby give consent to the staff of the Montessori School of Champaign-Urbana to provide care using basic First Aid techniques.
*
Yes
No
I hereby give consent to the Montessori School of Champaign-Urbana to take my child on walking trips in the neighborhood. This includes trips to Burwash Park for recreational purposes.
*
Yes
No
I hereby give consent to the Montessori School of Champaign-Urbana to publish my child's name and our names/email addresses on a family directory to be distributed to other families in the school.
*
Yes
No
I give my permission for my child to be photographed/filmed for use in MSCU publications, including but not limited to, publications via website or other technological publications, videos, newspapers, television, or social media.
*
Yes
No
Payment
Please choose how you would like to pay the $50.00 application fee:
*
Please note: Your application will not be processed until the $50.00 application fee has been paid.
Pay online immediately via electronic payment (debit or credit card)
Cash, check, or money order mailed directly to the MSCU office
Please put me on the waitlist for my child's selected program.
Would you like to pay the annual enrollment fee at this time?
*
Your child's spot will not be reserved until you have paid the annual enrollment fee. The fee is $400 for the first enrolling child, and $300 for each additional child who wishes to enroll concurrently.
Yes, I'd like to pay online immediately
Yes, I'll mail a check or a money order to the office ASAP. I understand that a spot will not be held for my child until the enrollment fee has been received.
No, I will pay later. I understand that a spot will not be held for my child until the enrollment fee has been received.
Please put me on the waitlist for my child's selected program.
Please select the choice that best describes your situation:
This is the ONLY application we will be submitting for our family.
This is the FIRST application we are submitting; we will submit sibling applications shortly as well.
This is NOT the first application we are submitting for our family.
Enrollment Fee
Your enrollment fee for this first application is $400.00, plus online payment processing fees.
Price:
$412.30
Sibling Enrollment Fee
Your enrollment fee for this sibling application is $300.00, plus online payment processing fees.
Price:
$309.30
Digital Signature
I hereby certify that I have read and answered this form to the best of my ability, and that all of the information furnished is true and correct.
*
Phone
This field is for validation purposes and should be left unchanged.
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