Application

Student General Information

First Name
Last Name
Hebrew Name
Gender
Date of Birth
Age
Place of Birth
Languages Spoken
Address
City
State
Zip
Phone
Cell Phone
Synagogue Affiliation

Family Information

Parent/Guardian A

First Name
Last Name
Address (if different than above)
City
State
Zip
Home Phone
Work Phone
Cell Phone
Occupation
Business Address
Email
Title of Position
Country of Origin
Jewish?

Parent/Guardian B

First Name
Last Name
Address (if different than above)
City
State
Zip
Home Phone
Work Phone
Cell Phone
Occupation
Business Address
Email
Title of Position
Country of Origin
Jewish?
Conversions/adoptions in the family
If yes, please specify
Send Correspondence to
Child's parents are
Do Parents share legal custody?
Do Parents share physical custody?
Name of Step-parent/s
Siblings of Applicant
Name
Date of Birth
Current School
Name
Date of Birth
Current School
Name
Date of Birth
Current School

Schools Child Previously Attended

Name of School
Dates of Attendance
School Phone Number
School Contact Person
Name of School
Dates of Attendance
School Phone Number
School Contact Person

Other Family / Student Information

Why do you think Alef Bet Preschool is a good fit for your family and your child?
What expectations do you have for your child's education at Alef Bet Preschool?
Please describe your child's social, cognitive and physical development. Include your child's particular strengths and weaknesses and any health conditions, allergies or experiences that would affect their experience at Alef Bet Preschool.
In what ways do you imagine your family could participate in the Alef Bet Preschool community (talents, resources or skills)?.
How did you hear about Alef Bet Preschool?
Is there any other information you feel we should know that would help us more fully understand your child or family?

Application Details

Preferred No. of Days Attending
Preferred Length of Day
Early Care?
Age anticipating child will attend until
School anticipating to attend after here

Personal References

Name
Phone
Name
Phone