Professional Documents
Culture Documents
Infant Toddler
Spring Summer
Early Childhood
Spring Summer
Personal Information
Last Name Preferred First Name Street Address City Phone (Day) State (Evening) First Name Maiden Name Apartment Number Zip Code Cellphone Number Country Email Middle Initial AMS Number
College Major
College Major
Post-Graduate Degree(s)
Degree/Credits Completed
Organization
CPUs
Amount received:
Check #:
Date:
How did you hear about Seton Montessori Institute? What aspects of your learning style should Seton be aware of? Please describe.
Language(s) Spoken
Montessori Certification Identify Montessori teacher credentials held and the organization granting the credential (eg. AMS, AMI or other).
Certification Program and Organization Certification Program and Organization Certification Program and Organization Location Location Location Date Certified/Level(s) of Certification Date Certified/Level(s) of Certification Date Certified/Level(s) of Certification
Employment Background
Current Employer Previous Employer Position Position From/To From/To
References (List the individuals who you have requested to write references for you)
Name Name Name Phone Phone Phone Position/Title Position/Title Position/Title Relationship to applicant Relationship to applicant Relationship to applicant
Documentation Needed to Submit a Complete Application are enclosed are on file College transcripts: Evaluation Reports: transcripts need to be evaluated (by WES.org or ece.org Evaluation Reports are enclosed is enclosed
is on file
A check for my application deposit is enclosed in the amount of: $500 (I understand that $100 of this is non-refundable should I not be accepted or choose to postpone or withdraw from the program). How will payments be made? Self Other
Non-Discrimination Statement It is the policy of Seton Montessori Institute not to discriminate against any individual on the basis of race, color, religion, national origin, sex, marital status, age or veteran status in matters of admissions, unemployment, or services or in the educational programs it operates, in accordance with civil rights legislation and institutional commitment. Admissions Deadlines We have priority admission deadlines for the following programs and will continue to accept applications after the priority deadlines (if space is available). March 1, 2013: Spring Infant-Toddler and Early Childhood Credential Programs May 1, 2013: Summer Infant-Toddler and Early Childhood Credential Programs April 30, 2012: Elementary I and Elementary I-II Credential Programs A $200 late enrollment fee will apply to applications processed after the published deadline.
I understand that my application will not be processed unless the following items have been received: $500 Application payment I have enclosed my transcripts/evaluation reports I am having my transcripts/evaluation reports sent directly to Seton Montessori Institute Please make all checks payable to: Seton Montessori Institute. Applications are dated upon receipt and acted upon in the order received. Enrollment is limited. You will be called for an interview as soon as your application is processed. Submit to: Seton Montessori Institute Attn: Elizabeth Norman, Admissions/Records Coordinator 5728 Virginia Avenue Clarendon Hills, IL 60514
Applicant Signature
Date