Gan Noe Preschool

Summer Application Form 

Click Here for Tuition Schedule

Student Information
Name of Student   Hebrew Name  
Address   Phone  
DOB   Email  
 
Student is Applying for Admission To:

Please Select Session

 
 

Session 1 (June 21 - July 16)
For Kitah Alef, Bet and Gimmel. 

 

Session 2 (July 19 - August 13)
For Kitah Alef, Bet and Gimmel.  

For Kitah Gimmel and older this includes 2 week (Aug 2 -Aug 13) Gan Izzy program. Must choose 5 day schedule.  9am -3:30pm. 

 

Gan Izzy Summer Experience (only)
2 weeks - Aug 2 - Aug 13. For Kitah Gimmel and older. Must choose 5 day schedule.  9am -3:30pm. 

Please Select Days
2 Day Program (Tues & Thursday)
3 Day Program
5 Day Program
 Please Select Schedule 
Half Day - 8:45 - 12:30
Full Day - 8:45 - 3:30
Extended Care - We are not offering extended care at this time. Please check this box if you would like to be notified of any changes. 
 
Parent Information
Parents #1 First Name   Parent #1 Last Name  
Parents #1 Email   Parent #1 Phone  
Parent #2 First Name   Parent #2 Last Name  
Parent #2 Email   Parent #2 Phone  
 
Emergency Contact
Emergency Contact Name   Phone  
Emergency Contact Name   Phone  
 
Payment Information - Form Must Be Submitted With a $350 Deposit
 
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