Name Registration Information Student - First Name * Student - Last Name * Date of Birth or Due Date * Child's Sibling Name (If currently at PLMS) Requested Start Date * Date of School Tour Date Submitting Waiting List Registration Form * Requested Entry Age of Student * Parent Information Mother/Legal Guardian Name Mother/Legal Guardian Email * Mother/Guardian Business Phone Number Mother/Guardian Cell Phone Number * Mother/Guardian Home Phone Number Father/Legal Guardian Name Father/Legal Guardian Email * Father/Guardian Business Phone Number Father/Guardian Cell Phone Number * Father/Guardian Home Phone Number Home Address Other Information What, in particular, attracts you to choose Pine Lake Montessori school for your child's education? * How did you hear about Pine Lake Montessori School? Advertising: Our Kids Advertising: Google Ads Advertising: Online 411 Advertising: Yellow Pages CCMA Website Newspaper or Magazine Referral by a friend or a family Other Mother/Legal Guardian Name Date Father/Legal Guardian Name Date I & my partner would like to receive emails from Pine Lake Montessori School
