2018-2020 Admission Application Personal Information Educational ...

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Name of Training Program. Organization (ex: AMS, AMI, other). Level. Date Credentialed. Name of Training Program. Organi
______________________ Date

2018-2020 Admission Application

Personal Information _____________________________________________________________________________________ Last Name

First Name

Date of Birth

_____________________________________________________________________________________ Address

City/State

Zip Code

_____________________________________________________________________________________ Phone

Email

Educational Background Please list all previous colleges/universities attended. Submit an original transcript from each institution and list additional institutions on a separate page. _____________________________________________________________________________________ High School

City/State

Graduation Date

_____________________________________________________________________________________ College/University

City/State

Dates Attended

_____________________________________________________________________________________ Major

Degrees/Credits Completed

Date Degree Received

_____________________________________________________________________________________ College/University

City/State

Dates Attended

_____________________________________________________________________________________ Major

Degrees/Credits Completed

Date Degree Received

_____________________________________________________________________________________ Graduate Degree

Degrees/Credits Completed

Graduation Date

Montessori Credential Please list all training courses completed or in progress. Do not list workshops or seminars attended.

______________________ Date

_____________________________________________________________________________________ Name of Training Program

Organization (ex: AMS, AMI, other)

Level

Date Credentialed

_____________________________________________________________________________________ Name of Training Program

Organization (ex: AMS, AMI, other)

Level

Date Credentialed

Employment Background _____________________________________________________________________________________ Current Employer

Position

Phone

Dates of Employment

_____________________________________________________________________________________ Previous Employer

Position

Phone

Dates of Employment

_____________________________________________________________________________________ Previous Employer

Position

Phone

Dates of Employment

References Please list the three professional associates that are providing written references. _____________________________________________________________________________________ Name

Position

Phone

Relationship to Applicant

_____________________________________________________________________________________ Name

Position

Phone

Relationship to Applicant

_____________________________________________________________________________________ Name

Position

Phone

Relationship to Applicant

Personal Essay Attach a typed personal essay of 400 words or more describing your academic and professional achievements and aspirations. Describe what interested you in Montessori education, why you have decided to become a Montessori professional, and why you have selected this program.

______________________ Date

Documentation Needed to Submit a Complete Application 1. Application Fee □ Non-refundable application fee of $200 2. Three References □ Enclosed in sealed envelopes □ Are being sent directly to NTMI 3. Original College Transcripts □ Are enclosed □ Are on File □ Are being sent 4. Independent Evaluation Report (if applicable) □ International transcripts need to be evaluated for US equivalency □ Evaluation Reports are enclosed 5. Montessori Credential Copy (if applicable) □ Is enclosed □ Is on file 6. Tuition Payments □ Self □ School Sponsored □ Other

_____________________________________________________________________________________ For Office Use Only

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Tour Receipt Catalog Catalog Agreement Tour Receipt Enrollment Agreement Record of Previous Education and Training Receipt of Enrollment Policies

______________________ Date

Acknowledgement I affirm that the information I have provided on this application form and all other admission application materials are complete, accurate and true to the best of my knowledge. I agree to submit other materials that are required for this admission application. I understand that furnishing false information on any part of this admission application may result in cancellation of admission or registration or both. I understand that the course for which I am applying must have sufficient enrollment for it to proceed, that I am responsible for payment of all fees, and that I must reserve money for materials and supplies. I further accept that the Director may modify the training course and schedule as circumstances may require. I understand that enrollment in this course does not guarantee certification or employment. I have read, understood and accepted all certification requirements and course requirements, which were provided with this application package.

________________________________________ Printed Applicant Name

________________________________________

__________________________________________

Applicant Signature

Date