DUPAGE DISCOVERY CAMP AT

DUPAGE MONTESSORI SCHOOL SUMMER 2014

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Young Scientists T-Ball Camp

Dinosaur Camp

Chess Camp

ENROLL NOW!

www.dupageschool.org 630-369-6899 Lego Camp

Welcome to DuPage Discovery Camp at DuPage Montessori School DUPAGE DISCOVERY CAMP at DuPage Montessori School is here! We are happy to present our Summer Camp Program Guide for 2014. We have exciting camps and field trips for the children to enjoy this summer. Our favorites return along with some new summer locations: the Planetarium for our Space Camp, Peck’s Farm with a butterfly house, the Field Museum for Dinosaur Camp, and Sarah’s pony rides and farm animal petting zoo. Our experienced, carefully selected, and well-trained staff have diverse backgrounds working with children. They bring their talents and enthusiasm to connect with each child’s unique personality and interests. Adam Darlage: Adam is our upper elementary teacher and holds a Ph.D. in History from the University of Chicago. Adam brings his love of history, cultures and languages to his students each day. He enjoys playing sports with his students and makes each day an exciting day of learning. Hadley Woodhouse: Hadley is our lower elementary teacher (6-9 yrs.) with a Masters in Education from DePaul University. Hadley’s background is in English and History and she is also a certified Art teacher. Hadley creates a curriculum to fit each child’s needs incorporating inspiring art projects to extend the process of learning. Chris Styles: Ms. Chris is a teacher in our Early Childhood (3-6 yrs.) program. Chris enjoys teaching with a hands on approach to creating materials and bringing in real life teaching experiences to her students. Chris has a passion for teaching the science camps (Dinosaurs, Bugs, Space Camp and Ocean Life) by bringing in new projects and incorporating Field Museum learning materials for the children to explore. Chris Dyslin: Chris teaches music for all ages during our regular school year and is a certified Music Teacher. She is well versed in everything from finger play with our younger students to Broadway musicals with our older students. Prabha Rajan: Prabha is an assistant in our Early Childhood (3-6 yrs.) program. She enjoys teaching arts and craft throughout the year at our school and is constantly creating new projects based on our curriculum. Colleen Breen: Colleen is an assistant in our Early Childhood (3-6 yrs.) program. She will be working in the Montessori classrooms during the summer. Robin Azarela: Robin is our teacher assistant with the first through third grade students throughout the year. She will teach the Horsing Around Camp, Art with the Masters Camp and Creation Station. Nelly Chatterjee: Nelly has taught for 21 years at our school, which shows her passion to teach and her dedication to her students. Nelly will be teaching in the Early Childhood (3-6 yrs.) program during the summer. Aileen Valencia: Aileen has been teaching for 19 years at our school. Her understanding of the Montessori approach shows in her patience and dedication to each student in her classroom. Aileen will be teaching in the Early Childhood (3-6 yrs.) program during the summer months. Maha Arakoni: Maha is a teacher in Early Childhood (3-6 yrs.) program and will teaching in the 3-6 yrs. classes and some camps as well. Maha has been with us as a parent, teaching intern and a teacher. She is a dedicated teacher that has the love of children as her guide in the classroom. Lynn Griffin: Lynn is a teacher in our Early Childhood (3-6 yrs.) program. She is essential in creating and coordinating the Summer Program and Camps we offer. Lynn will be teaching Space Camp this summer. Ken Diehl: Ken is a retired high school science teacher and performed demonstrations with his students at the Sci-Tech Museum. in Aurora. Ken will be teaching the Young Scientist Camp this summer. Evelyn Hermosa: Evelyn has been working with us through high school and college and is currently a pre-med student. She is a certified Zumba instructor and will be teaching sports camps as well. We are looking forward to a fun and exciting summer! Thank You,

Bob and Sharon Breen, Directors

CHOOSE FROM OUR PROGRAMS (Discovery Camps are for children ages 4 - 6 years old & Elementary) Rates for Discovery Camps and Classes are based on 5 consecutive week days.

Discovery Camps (Minimum 10 students per class) Ages: 4 - 6 years Hours: 9 a.m. - 12 p.m. Ages: 6 yrs. may choose a.m. or p.m. camps. Ages: Elementary Camps: 1st-8th grades Hours: 1 - 4 p.m.

Extended Hours: Extended hours are available before and after, the camps and educational programs.

$25 Credit for Each “NEW” Referral (New Sibling, Friend) Relative, Neighbor)

EARLY MORNING Times: 7:30 a.m. to 9 a.m. AFTER CARE Times: 4 p.m. - 6 p.m.

Montessori

Early Childhood Classes (3-6 yrs.) Classes are taught by Montessori Teachers. Ages: 3-6 years Half Day Hrs: 9:00 a.m.-12 p.m. ! 1:00 p.m.-4:00 p.m. Full Day Hrs. Available: 7:30 a.m.-6:00 p.m. Themes ! Week 1-Summer Garden Week 2-On the Farm -*Pony Rides Week 3-Exploring Music Week 4-Ocean Life Week 5-Celebrate America Week 6-All About Nutrition -*Lou Malnati’s Week 7-Mad Science-*Science Workshop Week 8-Community Helpers Week 9-Woodland Animals Week 10-Color Creations Week 11-Beach Party !

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* Field Trips

Elementary Educational Classroom Instruction Ages: Elementary Classes Half Day Hrs: 9 a.m.-12 p.m., 1:00 p.m.-4:00 p.m. Full Day Hrs. Available: 7:30 a.m.-6:00 p.m. The Elementary teachers will offer individualized instruction for academic skills, along with their daily instruction. They will take exciting field trips and enjoy many more summer activities. Summer Field Trips Week 2- Peck’s Farm Week 3- Ceramics Field Trip Week 4- Shedd Aquarium!! Week 6- Lou Malnati’s Pizzeria! Week 7- Science Workshop- In School! Week 8- Adler Planetarium Week 9- Medieval Times/ Lunch & Show! Week 10 -Legoland

Summer Camps MATH, SCIENCE & ENGINEERING CAMPS #202 It’s a Bug’s World Instructor: Ms. Chris

Date: Week 2, June 9-13 *(FT) Ages: 4 - 6 yrs: a.m. Elementary: p.m. We’ll look at other specimens to compare similarities and differences. We’ll also take an up close look at spiders to learn why they aren’t insects. PM campers will learn that insects are the most diverse animals on the planet. There are more than a million species of insects, representing more than half of all known living organisms.They will have an opportunity to invent their own insect. Field Trip Peck’s Farm with a Butterfly House in Geneva.

#701 Young Scientists

Instructors: Ms. Prabha a.m. and Mr. Ken p.m.

Date: Weeks 7, July 14-18(FT) Ages: 4 - 6 yrs: a.m. Elementary: p.m. Be a mad scientist in the DMS lab, with hands-on experiments and creative concoctions. Scientific concepts are really going to stick as you learn basic principles and watch them come alive right before your eyes. Projects include: Chinese rocket, Hover craft, Cartesian diver and Helicopter craft. Science Workshops in school.

#801 Diggin’ Dinosaurs Instructor: Ms. Chris

#802 Space Exploration

Date: Week 8, July 21-25 *(FT)

Date: Week 8, July 21-25*(FT)

Ages: 4 - 6 yrs: a.m Elementary: p.m.

Instructors: Ms. Lynn a.m., Mr. Adam, Ph.D., p.m. Ages: 4 - 6 yrs: a.m., Elementary: p.m. In this camp, children will spend a fun-filled week learning about space as they explore and create their own our solar system. Their imaginations will be expanded by the vastness of space. Field trip to Adler Planetarium in Chicago.

#401 Under the Sea Instructor: Ms. Chris

Date: Week 4, June 23-27*(FT) Ages: 4 - 6 yrs: a.m. Elementary: p.m. There’s more than fish in the sea! There are forests of kelp and black smokers. We’ll begin by learning about fish habitats and where in the ocean they live. We’ll make fish prints, taste seaweed, learn that starfish are not fish at all, and not all that lives in the ocean, swims. They will work on creating their own ocean ecosystem. Field trip to the Shedd Aquarium in Chicago.

Who came first Allosaurus or TRex? In this camp we actually set up a fossil dig! There will be dinosaur models and we’ll measure the biggest and the smallest. P.M. campers will study the Mesozoic Era Triassic, Jurassic and Cretaceous Periods. Since dinosaur fossils are usually found embedded in rock, paleontologists associate dinosaurs with the geologic period in which they lived--for example, "the sauropods of the late Jurassic." Field trip to the Field Museum in Chicago.

#901 Animals in Your Neighborhood Instructor: Ms. Robin

Date: Week 9, July 28- Aug. 1 Ages: 4 - 6 yrs: a.m. Elementary: p.m Campers will learn about the animals living in their backyards, parks and forests. They will learn about their habitats and learn the importance of our native animals. The will create their own animal book.

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* Field Trips

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LANGUAGE, MUSIC & LITERATURE #703 Young Authors AM Instructor: Ms. Chris

Date: Week 7, July 14-18 Ages: 4-6 yrs: a.m. Campers will learn the parts of a story (beginning, middle and end) and create the characters and plot by using their drawings and magazine pictures.They will be shown examples of different stories, brainstorm ideas, draw pictures, write and share each others stories.

#703 Creative Writing PM Instructor: Mr. Adam, Ph.D. Date: Week 7, July 14-18 Elementary: p.m. Students explore creative writing through storyboarding, short stories, and poetry. The focus is on the fundamentals of good fiction writing: the construction of plot, (beginning, middle, end), setting, and character development.  The instructor uses creative techniques to instill a love of writing.

STUDIO ARTS & CRAFT CAMPS (Cont.) #101 Garden Art

Instructor: Ms. Prabha

Date: Week 1, June 2-6 Ages: 4 - 6 yrs: a.m. Elementary: p.m. Summer begins by exploring the garden through colors and patterns. We explore the different types of gardens, learn about planting and create art projects around our theme.

#301 Ceramics and Clay Instructor: Ms. Prabha

Date: Week 3, June 16-20*(FT) Ages: 4 - 6 yrs: a.m. Elementary: p.m. Campers will use their imaginations by moulding clay and painting ceramics. Field Trip to “Color me Mine” to create a ceramic piece.

#402 Art with the Masters

Instructor: Ms. Robin

Date: Week 4, June 23-27

#302 Theater Camp

Ages: 4 - 6 yrs: a.m., Elementary: p.m.

Instructor: Ms. Chris Dyslin

Date: Week 3, June 16-20 Ages: 4- 6 yrs: a.m., Elem: p.m. In this musical theatre camp, students will have fun improving their singing, dancing and musical theatre acting skills. They will perform in a small musical at the end of the week.

STUDIO ARTS & CRAFT CAMPS #803 Messy Art

Instructor: Ms. Prabha

Date: Week 8, July 21-25 Ages: 4- 6 yrs am: Elem: p.m.

This camp explores art with color, shapes and design! Splatter art, squish painting, color mixing and hands on experiences!

This camp will focus on different artists such as: Van Gogh, Monet, Casset and DaVinci. We will learn a brief history of the artist we are replicating along with different painting techniques and skills.

#902 Photography

Instructors: Ms. Maha a.m., Ms. Prabha, p.m.

Date: Week 9, July 28-Aug. 1

Ages: 4 - 6 yrs: a.m., Elementary: p.m. Campers will learn the basics of photography and camera use, as well as a brief history about the origin of photography. Younger students will learn how to operate a camera and take successful pictures. Older students will learn how to operate a camera, and go more in depth with the functions. Campers need to supply their own disposable cameras.

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*(FT) Field Trip

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#603 Creation Station (AM ONLY) Instructor: Ms. Robin

#201 Horsing Around (AM ONLY) Date: Week 2, June 9-13

Ages: 4-6 yrs.

Instructor: Ms. Robin Ages: 4 - 6yrs.

Date: Week 6, July 7-11 Creations will include toothpick sculptures, modeling clay dough, pine cone creations, and a week long project using paper-mâché.

EXPLORATION CAMPS #203 When in Rome... (PM ONLY) Instructor: Mr. Adam, Ph.D., History Date: Week 2, June 9-13

Children will learn about the care of a pony and equipment such as; the saddle, reins and bridle. Field trip to our Wheaton school for a pony ride and petting zoo with farm animals.

#601 Young Chefs

Ages: Elem. p.m

Instructor: Ms. Prabha

Students explore the history, culture, and geography of ancient Rome as well as the Latin language. Students will build a model of the Colosseum with other fun projects, including building battle formations with toy Roman soldiers. 

Ages: 4 - 6 yrs: a.m. Elementary: p.m.

Date: Week 6, July 7-11 *(FT)

#903 Castles, Knights and Queens! *(FT) Instructors: Ms. Prabha a.m. Mr. Adam, Ph.D., History Date: Week 9, Jul. 28-Aug 1 Ages: 4 - 6 yrs: a.m., Elem: p.m.

Children will use different materials to construct and decorate their castle. In the PM, Mr. Adam will teach the history of Europe during the Medieval time period and explore the lives of the royalty, tradesman and farmers. Field Trip to Medieval Times, including a meal and performance.

#1001 Legos *(FT)

Instructors: Ms. Prabha a.m. Mr. Adam p.m.

Date: Week 10, Aug 4 - 8 Ages: 4 - 6 yrs: a.m. Elementary: p.m. Put your engineer’s cap on and come explore everything with LEGO building. In this camp children will design and assemble their own models. Field trip to LEGOLAND Discovery Center in Schaumburg.

Children will learn measurements, basic cooking skills and recipes for making snacks that do not require any cooking. At the end of the week they will come home with their very own cookbook. Field Trip to Lou Malnati’s Pizzeria in Naperville to make a pizza.

#602 Chess (PM ONLY) Instructor: Mr. Adam

Date: Weeks 6, July 7-11 Ages: 5 - 6 yrs.(Child must be able to read) Elementary: p.m. This is a fun and exciting way to learn about chess. No previous experience is necessary. Each class will consist of time spent learning the basics of chess through a guided teaching period and time spent solving problems using logic.

*(FT) Field Trip

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SPORTS CAMPS #303 T-Ball Camp/Softball Date: Week 3, June 16-20 Ages: 4 -6 yrs. a.m. - T-Ball Elementary p.m. -Softball Young campers will learn the basic introduction to T-ball and Softball including hitting, catching, and throwing. They will have fun and learn about team work.

#403, #702 ZUMBA Date: Week 4, June 23-27 Week 7, July 14-18 Ages: 4 - 6 yrs. a.m. Elementary p.m. Instructor: Ms. Evelyn, Certified Zumba Instructor This camp is for kids who like to turn up the music, wiggle, and giggle. This camp is mixed with a dynamic aerobics and obstacle course challenging for kids.

#102, #1101 Soccer Date: Weeks 1 & 11, June 2-6, Aug 11-15

#604 Kickball, Red Rover, Freeze Tag Date: Week 6, July 7-11

Ages: 4 - 6 yrs. - a.m. Elementary p.m.

Ages: 4- 6 a.m. Elementary p.m.

This is a great way for campers to get outside and be active while learning valuable skills to help with coordination, teamwork and selfconfidence.

Regular active play helps children to develop a lifelong habit of daily exercise. Children will learn how to play the age old games that gave us joy in our childhood. The children will learn team sportsmanship and different strategies for different games. They will also get an understanding of social rules, build friendships, get a sense of 'give and take', and learn patience and perseverance.

#501, #1002 All Sports Date: Weeks 5 & 10, June 30-Jul. 3, August 4-8 Ages: 4 - 6 yrs. a.m., Elementary p.m. This camp is designed for campers who want to learn a new sport each day. The campers will participate in basketball, kickball, soccer and many other team activities. The various sports allows for building a variety of skills, allowing each child to find something fun and to fit each child’s abilities. Participating in sports builds a child's self-esteem while teaching teamwork.

*Water bottles requested daily for sport camps. Bring your own soccer balls, basketballs, softballs and mitts.

All personal items must be labeled with children’s name.

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Summer at a Glance

J U N E J U L Y J U L Y / A U G

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6

7

9 10 11 12 13 #201*HORSING AROUND (AM ONLY) #202 * IT’S A BUG’S WORLD #203 WHEN IN ROME (PM ONLY)

14

WEEK 1 WEEK 2

3

4

#101 GARDEN ART

5

#102 SOCCER

16 WEEK 3 WEEK 4

17 18 19 #301 *CERAMICS & CLAY #302 THEATER CAMP #303 T-BALL/SOFTBALL

JUNE 30

7

WEEK 8

1 2 #501 ALL SPORT

3

Closed 4

5

8

9

10

11

13

15

18

19

25

26

1

2

8

9

15

16

16

17 #701 *YOUNG SCIENTISTS #702 ZUMBA 22 23 24 #801 *DIGGIN DINOSAURS #802 *SPACE CAMP #803 MESSY ART

28 29 30 31 #901 ANIMALS IN YOUR NEIGHBORHOOD #902 PHOTOGRAPHY #903 *CASTLES, KNIGHTS, and QUEENS 4

5 #1001*LEGOS

11

12

WEEK 10

WEEK 11

28

#703 AM: YOUNG AUTHORS #703 PM: CREATIVE WRITING

21

WEEK 9

27

#601 *YOUNG CHEFS #602 CHESS (PM ONLY) #603 CREATION STATION (AM ONLY) #604 KICKBALL, RED ROVER &

14 WEEK 7

21

23 24 25 26 #401 *UNDER THE SEA #402 ART WITH THE MASTERS #403 ZUMBA

WEEK 5 WEEK 6

20

6 7 #1002 ALL SPORT

13 #1101 SOCCER

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* Field Trip

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PARENT’S COPY - KEEP FOR YOUR SCHEDULE

Programs

Weekly Fees:

Week 1 6/2 - 6

AM Early Morning Care 7:30 -9am

CAMPS AM: 9 - 12 ___4-6 Yrs

Class Only HALF Days ___AM: 9 -12 ___ PM: 1 - 4

PM: 1 - 4 ___6-12 Yrs

$15

Circle One Camp $150

Fee: _____

101 Garden Art 102 Soccer Fee: ______

___ 3-6 Yrs ___ 6-12 Yrs

$130

+

Full Day Camp

___4-6 Yrs ___6-12 Yrs Circle One Camp $250

Full Day 9 - 4pm

$230

PM Care 4-6pm

Field Trip Fee

Total

$20

$25 *(Except Medieval Times- $45)

Please total all boxes below

Fee:_____

Elementary will go on all field trips w/ camps. *3-6 yrs. will go: Weeks 2, 6 & 7

Fee:_____

101 Garden Art 102 Soccer Fee: ______

Fee:_____

201 Horses am 202 Bugs 203 Rome pm Fee: ______

Fee:_____

Fee:_____

*Pony Rides: 3-6 yrs or Bugs Camp/Elem Peck Farm $25

Fee:_____

Fee:_____

Ceramics/Elem. Color Me Mine $25 Under the Sea Camp/Elem. Shedd Aquarium $25

Fee:_____

Fee:_____

201 Horses am 202 Bugs 203 Rome pm Fee: ______

Week 3 6/16 - 20

Fee:_____

301 Ceramics 302 Theater 303 T-Ball/Soft Fee: ______

Fee:_____

301 Ceramics 302 Theater 303 T-Ball/Soft Fee: ______

Week 4 6/23 - 27

Fee:_____

401 Sea 402 Art 403 Zumba Fee: ______

Fee:_____

401 Sea 402 Art 403 Zumba Fee: ______

Fee:_____

Fee:_____

Week 5 6/30 - 7/3

Fee:_____

501 All Sport Fee: ______

Fee:_____

501 All Sport Fee: ______

Fee:_____

Fee:_____

Week 2 6/9 - 13

Week 6 7/7- 7/11

Fee:_____

601 Chefs 602 Chess pm 603 Creation am 604 Kickball

Fee:_____

601 Chefs 602 Chess pm 603 Creation am 604 Kickball

Fee:_____

Fee:_____

*Cooking Camp/ 3-6 yrs./Elem *Lou Malnati’s $25

Fee:_____

Fee:_____

*Science Workshops $25 Dinosaurs Field Museum Space Camp Adler Planetarium

Fee: _______

Fee: _______

Fee:_____

701 Scientists 702 Zumba 703 Writing Fee: ______

Fee:_____

701 Scientists 702 Zumba 703 Writing Fee: ______

Fee:_____

801 Dinosaurs 802 Space 803 Messy Art Fee: ______

Fee:_____

801 Dinosaurs 802 Space 803 Messy Art Fee: ______

Fee:_____

Fee:_____

Week 9 7/28 - 8/1

Fee:_____

901 Animals 902 Photo 903 Castles Fee: ______

Fee:_____

901 Animals 902 Photo 903 Castles Fee: ______

Fee:_____

Fee:_____

Week 10 8/4 - 8/8

Fee:_____

1001 Legos 1002 Sports Fee: ______

Fee:_____

1001 Legos 1002 Sports Fee: ______

Fee:_____

Fee:_____

Week 11 8/11 - 8/15

Fee:_____

1101 Soccer Fee: ______

Fee:_____

1101 Soccer Fee: ______

Fee:_____

Fee:_____

Week 7 7/14-18

Week 8 7/21 - 25

TOTAL:

Castles Camp Medieval Times

*$45 Lego Camp/Elem Legoland $25

SCHOOL COPY - KEEP FOR YOUR SCHEDULE Child’s Name ______________________________________________ Age________

Programs

Weekly Fees:

Week 1 6/2 - 6

AM Early Morning Care 7:30 -9am

CAMPS AM: 9 - 12 ___4-6 Yrs

Class Only HALF Days ___AM: 9 -12 ___ PM: 1 - 4

PM: 1 - 4 ___6-12 Yrs

$15

Circle One camp $150

Fee: _____

101 Garden Art 102 Soccer Fee: ______

___ 3-6 Yrs ___ 6-12 Yrs

$130

+

Full Day Camp

___4-6 Yrs ___6-12Yrs Circle One camp $250

Total

$20

$25 (Except Medieval Times- $45)

Please total all boxes below

Fee:_____

Elementary will go on all field trips w/ camps. *3-6 yrs. will go: Weeks 2, 6 & 7

Fee:_____

201 Horses am 202 Bugs pm 203 Rome Fee: ______

Fee:_____

Fee:_____

*Pony Rides: 3-6 yrs or Bugs Camp/Elem Peck Farm $25

Fee:_____

301 Ceramics 302 Theater 303 T-Ball/Soft Fee: ______

Fee:_____

Fee:_____

Ceramics/Elem. Color Me Mine $25

Fee:_____

Fee:_____

Under the Sea Camp/Elem. Shedd Aquarium $25

Fee:_____

Fee:_____

Fee:_____

Week 3 6/16 - 20

Fee:_____

301 Ceramics 302 Theater 303 T-Ball/Soft Fee: ______

Week 4 6/23 - 27

Fee:_____

401 Sea 402 Art 403 Zumba Fee: ______

Fee:_____

401 Sea 402 Art 403 Zumba Fee: ______

Week 5 6/30 - 7/3

Fee:_____

501 All Sport Fee: ______

Fee:_____

501 All Sport Fee: ______

Fee:_____

Field Trip Fee

Fee:_____

Week 2 6/9 - 13

Week 6 7/7- 7/11

$230

PM Care 4-6pm

101 Garden Art 102 Soccer Fee: ______

201 Horses am 202 Bugs pm 203 Rome Fee: ______

601 Chefs 602 Chess pm 603 Creation am 604 Kickball

Full Day 9 - 4pm

Fee:_____

Fee: _______

601 Chefs 602 Chess pm 603 Creation am 604 Kickball

Fee:_____

Fee:_____

Fee:_____

*Cooking Camp/ 3-6 yrs./Elem *Lou Malnati’s $25

Fee: _______

Week 7 7/14-18

Fee:_____

701 Scientists 702 Zumba 703 Writing Fee: ______

Fee:_____

701 Scientists 702 Zumba 703 Writing Fee: ______

Fee:_____

Fee:_____

*Science Workshops $25

Week 8 7/21 - 25

Fee:_____

801 Dinosaurs 802 Space 803 Messy Art Fee: ______

Fee:_____

801 Dinosaurs 802 Space 803 Messy Art Fee: ______

Fee:_____

Fee:_____

Dinosaurs Field Museum Space Camp Adler Planetarium

Week 9 7/28 - 8/1

Fee:_____

901 Animals 902 Photo 903 Castles Fee: ______

Fee:_____

901 Animals 902 Photo 903 Castles Fee: ______

Fee:_____

Fee:_____

Week 10 8/4 - 8/8

Fee:_____

1001 Legos 1002 Sports Fee: ______

Fee:_____

1001 Legos 1002 Sports Fee: ______

Fee:_____

Fee:_____

Week 11 8/11 - 8/15

Fee:_____

1101 Soccer Fee: ______

Fee:_____

1101 Soccer Fee: ______

Fee:_____

Fee:_____

TOTAL:

Castles Camp Medieval Times

*$45 Lego Camp/Elem Legoland $25

Du Page Montessori School 24 W. 500 Maple Ave. Naperville, IL 60540 630-369-6899

Summer Application 2014

Early Registration Fee $15 -Due by April 30. Registration Fee $30 (non-refundable) Programs: 3 - 6 years Elementary

Child Information:

Male

Female

___________________________________________________________ First Middle Last Name _______________ Date of Birth!

______ ___________________________________ Age Place of Birth

Parent (Guardian) Information:

Parent (Guardian) Information:

________________________________________________ Mother’s Name

_______________________________________________ Father’s Name

________________________________________________ Mother’s home address

_______________________________________________ Father’s home address

________________________________________________ City State Zip

_______________________________________________ City State Zip

________________________________________________ Home phone: area code - number

_______________________________________________ Home phone: area code - number

________________________________________________ Mother’s Cell phone: area code - number

_______________________________________________ Father’s Cell phone: area code - number

________________________________________________ Mother’s Email Address

_______________________________________________ Father’s Email Address

________________________________________________ Mother’s Occupation

_______________________________________________ Father’s Occupation

________________________________________________ Mother’s Company Name

_______________________________________________ Father’s Company Name

________________________________________________ Company City State Zip

_______________________________________________ Company City State Zip

________________________________________________ Company phone: area code - number

_______________________________________________ Company phone: area code - number

Marital Status (circle one): married, single, divorced

Marital Status (circle one): married, single, divorced

Child’s brothers and sisters:

Important Health Information:

_________________________ _________________________ Name Age Name Age

Allergies: __________________________________________ __________________________________________________ Health Restrictions:___________________________________ __________________________________________________ Physical Impairments:_________________________________

_________________________ _________________________ Name Age Name Age

Permissions: I grant permission to the school to take my child on school sponsored field trips, and to include him or her in school photographs and evaluation programs. ! !

_____________________________________! ! Signature of Parent or Guardian

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_________________ ! date