Enrolment Form

Dear Parent, thank you for considering Little People as a future pre-school for your child.

A number of factors are taken into account when offering places:
- Order of enrolment
- The need to maintain a balance of gender and age in the school
- Preference given to siblings of children already attending
- Preference given to children who intend to complete the full 3 year Montessori pre-school programme
- Preference given to children transferring from other Montessori pre-schools
- Children must be at least 2 years old and toilet trained.

The following information/documentation is to be submitted with the enrolment form:
- A copy of your child’s “Road to Health” Card and Vaccination Record
- Copy of Parents’ IDs
- Certified copy of Child’s Unabridged Birth Certificate

When a Child is transferring from another school:
- Copies of Child’s Academic Records and Reports
- Reports from Specialists if applicable

On Acceptance:
- A signed copy of Policy and Procedure: Terms and Conditions
- A signed copy of the Consent and Indemnity

A non-refundable application fee of R7500 is payable on submission of the completed enrolment form (“the Application Fee”).
Bank : NEDBANK
Branch : SEA POINT
Account name : THE SHELLEY BERGMAN MONTESSORI PRE-SCHOOL CC
Account number : 124 698 6604
Branch code : 198 765
Kindly use your child's name as reference.
Email proof of payment to : lilpeople@iafrica.com

Shelley Bergman

CHILD

Full name *

Gender *

Proposed Date of Entry *

Preferred Name *

Date of Birth *

Home Language *

Religion *

Nationality *

THE FAMILY

Marital Status of Parents *

Who does the child live with? *

Number of children in family *

Position of child *

SIBLINGS

Name

Gender

Date of Birth

School

Name

Gender

Date of Birth

School

If your child is adopted, a foster child, or a step child:

Please provide any information regarding the child’s past history or custody arrangements that will be helpful to the staff.

PARENT 1

Full name *

SA ID no. (or International Passport no.) *

Occupation & Company Name *

Home Address *

Mobile no. *

Email address *

Telephone (Business) *

PARENT 2

Full name

SA ID no. (or International Passport no.)

Occupation & Company Name

Home Address

Mobile no.

Email address

Telephone (Business)

*In the case of emergency, which parent should be contacted? *

ACCOUNTS

Person responsible for the account:

Name *

Mobile no for accounts *

Email for accounts *

MEDICAL

Doctor name *

Doctor Mobile / Telephone *

Doctor address *

Dentist name *

Dentist Mobile / Telephone *

Dentist address *

Medical Aid Scheme *

Medical Aid number *

MEDICAL HISTORY

*Please note: parents/guardians are responsible for ensuring that this information remains up to date in the event that your child develops conditions/illnesses subsequent to the completion of this form.

Provide full particulars of any chronic illnesses or special medical needs (including disability(ies) or communicable disease(s)) which your child may have (include duration of condition and diagnosis as well as symptoms which may present): *

Provide instructions (i.e. how to manage in your child in the event of a manifestation of the condition as well as the treatment procedure to be adopted and the preferred symptomatic control) in relation to such special medical needs or chronic illnesses and the administration of any medication in the treatment thereof (specify medication name strength, storage instructions and dosage): *

Is your child allergic to any kind of medicine, injection, tablet, food or insect bite etc? *

Provide treatment procedure/symptomatic control in the event of a manifestation of the allergy: *

Medication in the event of a manifestation of the allergy (specify name strength, storage instructions and dosage): *

*Please note: In the event that Little People is required to administer any medication to your child you are required to provide adequate quantities of such medication to Little People in advance and ensure that such medication has not expired)

Has your child any problems with any of the following : *

If yes, please specify diagnosis: *

Are there any areas where you feel that your child would need special assistance? *

Has your child had any serious accidents or operations (eg tongue tie)? *

Has your child ever been referred to a Psychologist/Behavioural Specialist/Occupational Therapist/ Speech Therapist/Physiotherapist? If yes, please provide details. *

Would you as the parent wish to be informed should Little People be concerned that your child may have a psychological/emotional disorder, physical or learning disability? *

Have any members of the family had learning difficulties or disabilities? If yes, please provide details. *

Are there any medical conditions in other members of the family e.g. Deafness, Allergies etc? *

Provide some information on your Pregnancy with the child? *

Provide some information on your birth experience? (natural/caesarean etc) *

Was the child breast fed or bottle fed? *

MEDICAL EMERGENCY CONTACT

In the event of an emergency, if the parent/s cannot be contacted, please provide alternatives:

1. Name & Mobile number *

2. Name & Mobile number *

GENERAL

Who will bring and fetch your child to and from pre-school (please note for security purposes these persons will be required to identify themselves the first time they fetch your child from Little People)? *

Indicate your child’s particular strengths and/or deficiencies (physical, emotional, intellectual): *

Does your child have any fears or phobias? *

What are your child’s special interests? *

Are your child’s grandparents living? Where? *

Does the family live in a house or a flat? *

Does your child have his/her own bedroom? *

Does your child have access to a garden? *

What type of discipline is used in the home? *

How does your child react on being left alone? (Separation Anxiety) *

Is your child toilet trained? *

At what time does your child go to sleep at night? *

Does your child nap during the day? *

Has your child attended nursery/pre-school/crèche or classes before (if yes, where)? *

As a parent, what are your expectations of pre-school? *

What are your expectations of your child? *

Why have you chosen Montessori for your child? *

Why is Little People your school of choice? *

Where did you hear about us? *

Are you able to attend parents’ evenings, school functions, and involve yourself at Little People? *

Do you have skills and areas of expertise you would be prepared to offer the school? *

Do you intend enrolling your child for the full 3 year Montessori programme at Little People? *

School considered for Grade 1 *

Do you agree to photographs taken of yourself and or your child at school or on any school organised outing or event to be used for the purpose of teaching, record keeping, advertising or social media for Little People? *

Is there any other information of importance which Little People should know about? *

Are there other problems you would like to discuss privately? *

PLEASE UPLOAD THE FOLLOWING DOCUMENTS

1. A copy of your child’s “Road to Health” Card and Vaccination Record *

2. Copy of Parents’ IDs *

3. Certified copy of Child’s Unabridged Birth Certificate *