Student General Information
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First Name
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Last Name
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Hebrew Name
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Gender
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Date of Birth
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Age
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Place of Birth
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Languages Spoken
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Address
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City
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State
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Zip
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Phone
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Cell Phone
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Synagogue Affiliation
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Family Information
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Parent/Guardian A
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First Name
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Last Name
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Address (if different than above)
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City
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State
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Zip
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Home Phone
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Work Phone
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Cell Phone
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Occupation
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Business Address
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Email
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Title of Position
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Country of Origin
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Jewish?
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Parent/Guardian B
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First Name
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Last Name
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Address (if different than above)
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City
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State
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Zip
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Home Phone
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Work Phone
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Cell Phone
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Occupation
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Business Address
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Email
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Title of Position
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Country of Origin
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Jewish?
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Conversions/adoptions in the family
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If yes, please specify
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Send Correspondence to
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Child's parents are
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Do Parents share legal custody?
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Do Parents share physical custody?
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Name of Step-parent/s
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| Siblings of Applicant |
Name
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Date of Birth
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Current School
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Name
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Date of Birth
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Current School
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Name
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Date of Birth
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Current School
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Schools Child Previously Attended
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Name of School
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Dates of Attendance
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School Phone Number
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School Contact Person
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Name of School
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Dates of Attendance
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School Phone Number
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School Contact Person
|
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Other Family / Student Information
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Why do you think Alef Bet Preschool is a good fit for your family and your child?
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What expectations do you have for your child's education at Alef Bet Preschool?
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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.
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In what ways do you imagine your family could participate in the Alef Bet Preschool community (talents, resources or skills)?.
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How did you hear about Alef Bet Preschool?
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Is there any other information you feel we should know that would help us more fully understand your child or family?
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Application Details
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Preferred No. of Days Attending
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Preferred Length of Day
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Early Care?
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Age anticipating child will attend until
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School anticipating to attend after here
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Personal References
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Name
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Phone
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Name
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Phone
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