Montessori Schools of Massachusetts
Membership Application
www.MSMResources.org
Name of
School______________________________________________________________
Address____________________________________________________________________
____________________________________________________________________
Affiliations/Licensing (check all that
apply):___AMS___AMI___EEC___AISNE___NAEYC
____Other:_______________________________
Type of School: __private, non-profit __private,
proprietary __public __charter __other :______________
School
Telephone#________________________Fax#_______________________________
E-mail address__________________________
Website_____________________________
Head of
School______________________________________________________________
Head of School E-mail address__________________________________________________
Assistant Head of School or
Curriculum Coordinator_______________________________________________________
Assistant Head E-mail Address_________________________________________________
STUDENT INFORMATION: (Please record the number of students at each
level)
Infant/Toddler___________Primary (3-6)__________Lower
Elementary(6-9)____________
Upper Elementary(9-12)_______Jr. High/Middle
(12-15)_____________Other:__________
Total # of students enrolled:______________
Fee Enclosed
_____$ 25.00 (school enrollment 1-24 students)
_____$ 50.00 (school enrollment 25-49 students)
_____$100.00 (school enrollment 50-99 students)
_____$150.00 (school enrollment 100-149 students)
_____$200.00 (school enrollment 150-199 students)
_____$225.00 (school enrollment 200 + students)
Please make checks payable to : Montessori
Schools
of Massachusetts
Mail to: Gail M. Supanich
1346 Parker Street
Springfield, MA 01129-1055
Questions on membership contact Gail Supanich at gsupanich@excell.net or 413-782-6836