NEW STUDENT APPLICATION Tuition Schedule - Click Here Student Information First Name Last Name Hebrew Name Phone Address Zip Code DOB Place of Birth Previous daycare/schooling experience School Dates Choose a Program 2 Day(Tue & Thurs) 3 Day (Mon. Wed. & Fri.) 5 Day 1st Choice 2nd Choice Half Day 8:45-12:30 Full Day 8:45-3:30 Extended Day 8:45-4:45pm When do you want to start Family Orientation Fathers name Jewish Yes No Home Address if different Occupation Business Phone Business Address Cell Phone . Email Mothers name Jewish? Yes No Home Address if different Occupation Business Phone Business Address Cell Phone Email Marital Status of Parents Married Separated Divorced Single Parent If Divorced - how long? Family Affiliation Name of Synagogue Name of Rabbi Languages Spoken at Home Siblings Name Age School Name Age School Getting to Know Your Child What are your child's favorite activities What do you perceive to be your child's strengths What are your child's favorite foods Please share with us how you discipline your child at home Which words do you use when complimenting your child Which words do you use when discipline your child Do you have any concerns regarding your child that you would like us to be aware of What are you hoping your child will gain and learn at school this year If you could create a perfect a school setting for your child, how would you describe it $ 75.00 Application Fee First Name on Card Last Name on Card Credit Card Type Credit Card Number Exp Date CVV Billing Address Billing City Billing State Billing Zip Phone Number Amount This page uses 128 bit SSL encryption to keep your data secure.
