Document 64542

 Thumbprint Montessori
Children’s House
College Preparatory Montessori
Learning Community
9390 N. Florida Avenue
Tampa, Florida 33612
Ph: 813.930.2988 Fax: 813.930.2929
Anticipated grade level for 2014-2015
3 Year-Old ___ VPK____
Application is not complete unless the following items are brought in with this form:
___Updated Immunization and health records ___Birth certificate
Student Information First Name Middle Name Last Name Address City, State Zip Code Male____ Female____ Age: _____ D.O.B. : ___/___/20___ Race/Ethnicity Survey (Answer Y for Yes or N for No)
Hispanic____ American Indian____ Asian____ Black____ Islander____ White____
Emergency Contact Information/Health Information
It is imperative that this information be kept up-to-date and correct during the school
year. This is important for school information and for your child’s safety at our school.
Please provide name, address and phone number for each of the following:
This information is important. Please fill out updated address and phone information.
1. Name of Parent/Guardian: _____________________________
Phone:____________ Address:________________________________________
2. Name of Parent/Guardian: _____________________________
3. Referred by: Name:_____________________________ Phone:_____________
Name of Primary Care Physician:_________________________ Phone____________
Medical problems currently being addressed:__________________________________
Medications child is currently taking:_________________________
Child’s Drug Allergies:____________________________________
Child’s Food Allergies:___________________________________
Child on Special Diet: Yes___ No____ (NOTE) All allergies must be documented.
Emergency Contact Data
(This information is important and needs to be updated at all times.)
Name_____________________________________________ Phone________________
Name_____________________________________________ Phone________________
Name_____________________________________________ Phone________________
Name_____________________________________________ Phone________________
In case of accident or serious illness, the school will contact the parent/guardian.
If the school is unable to contact the parent/guardian or person(s) designated above, the
school will contact the physician or will make the necessary arrangements for immediate
transportation and treatment. Payment of fees will be assumed by the parent/guardian.
I have reviewed and understand the conditions of this document and I understand
that if I desire to have my child released to persons other than those listed above, I must
provide a list of those persons in writing, with addresses and telephone numbers, to the
principal of the school.
Important Note:
Our facilities are NOT equipped with the necessary accommodations for your
child who is not potty trained. We will not accept any children who cannot go to the
bathroom on their own. If you do enroll your child and going to the potty is or becomes a
hindrance, we will exercise the right to remove your child until they can do this on its
Breakfast/Snack/Lunch/Dinner Schedule
A.M Snack Noon Meal P.M. Snack Dinner Snack Evening
Signature of Parent/Court-Appointed Guardian
The Richardson
Montessori Academy
College Preparatory Montessori
Learning Community
9390 N. Florida Avenue
Tampa, Florida 33604
Ph: 813.930.2988 Fax: 813.930.2929
School Material List
Grades 1-6
8 composition books (replenished as needed)
3 well-sharpened pencils, daily (only 3 – do not send your child with a hand-held
1 bar eraser
1 soft, cloth or net, pencil pouch (NO HARD PENCIL BOXES)
1 box of 12- or 24- count color pencils
1-2: note binder
1. Children’s Student’s Dictionary
2. Student Thesaurus
These two items are an investment in your child’s education!!!! Taken
care of properly, they will last well into adulthood.
3. Children’s Atlas (The Montessori child begins immediately to study about the
Small pkg. of sheet protectors
Plastic storage container – Please no larger than 15 or 16 quarts. All large, crate type
containers will be returned to you!
1-cloth napkin, daily, every day, with proper eating utensil (if needed)!
And lastly, a huge does of discipline, obedience to adults and common
courtesy taught at home!
9390 N. Florida Avenue
Tampa, Florida 33604
The Richardson
Montessori Academy
Ph: 813.930.2988 Fax: 813.930.2929
College Preparatory Montessori
Learning Community
School, Student and Family Contract
Montessori philosophy, the charter law
and embodies those ideals that are
chosen for our specific school. First, the
contract is designed to ensure a safe,
secure and healthy learning environment
for all students and personnel at The
Richardson Montessori Academy.
guidelines are listed below, no written
contract can replace respect, trust, and
reasonable judgment of people who
want to do the RIGHT THING.
As a preparatory Montessori
school, The Richardson Montessori
Academy is to provide an environment
conducive to scholarship. The school
and parents’ goal must be one and the
same, academics, and all agree to work
together towards that end.
Dishonest behavior (cheating on
classwork, tests, etc.) will lead to
disciplinary action including
possible dismissal
Scholarship extends will beyond
the classroom and all homework
assigned must be turned in
area disruption to the educational
process and undermines the
student’s opportunity to learn and
Student should wear the school
I will not put over-the-counter
medication to be dispensed by
the child, in our child’s
maintaining a healthy and safe
learning environment. Our child
is responsible for cleaning up
after themselves at school
Our child will not display any
fashion that will be a distraction
from the mission: body piercing,
(mohawks, engravings cut into
hair) or other inappropriate
fashions that might spread
throughout the school
We will respect community
areas, school property, and the
property of others.
We understand that it is a
requirement for the Richardson
Montessori Academy to tutor
students. Parents are required to
provide a way for their children
to participate.
Parents (or someone in their
stead) must give 30 hours of
yearly volunteer service that will
benefit the school and encourage
learning in their children and
others. Not volunteering in some
form warrants dismissal from the
In return, The Richardson Montessori Academy Agrees to:
Be non-sectarian and non-discriminatory in our programs and admission
Be accountable to the State of Florida Department of Education for our
Not charge tuition
Health, safety and welfare for all students
Continuous improvement planning and evaluations
Tutorial sessions
I/We have read and agree to abide by the rules and regulations of TRMA
School Board as stated in the contract.
I agree that my child’s photograph may become part of the pamphlets,
brochures, newspapers, etc. unless the Head of School receives written
notice of the contrary.
Father/Male Guardian
Mother/Female Guardian
Contract to be signed with application in hand.
without Parent-Student Contract.
No application is complete