Preschool Registration Form

Child's First Name:     

Child's Jewish Name:  

Child's Last Name:

Child's Date of Birth:

Address:     

City:        State:  

ZIP:    Phone:

E-mail:

Father's First Name:  

Father's Last Name: 

Father's Jewish Name: 

Mother's First Name: 

Mother's Last Name: 

Mother's Jewish Name: 

Comments: 

You will be contacted about your registration.  A full application package will be sent to potential students.   Scholarships are available.