2023-2024 Parenting Program Application

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Admission to the Parenting Program is based on availability and is not guaranteed by the submission of this form. An application fee ($18 for temple members, $36 for non-members) will be charged upon submission of this form.

Priority for admission is given to:
1. Siblings of families currently enrolled in the Nursery School.
2. Temple members (within this group, priority is given according to the length of your membership).
3. Non-members through a random selection.
4. Any remaining spots will be filled on a first-come, first-served basis after the previous criteria have been met.

CHILD'S INFORMATION

* Child: First Name

* Child: Last Name

* Child: Date of Birth

* Child: Gender

Class Preference

* Class Preference

PARENT(S) INFORMATION

* Parent 1: First Name

* Parent 1: Last Name

* Parent 1: Home Address

Parent 1: Home Address (2)

* Parent 1: City

* Parent 1: State

* Parent 1: Mobile

* Parent 1: Email

Parent 2: First Name

Parent 2: Last Name

Parent 2: Mobile

Parent 2: Email

Does Parent 2 have a different address?

* Parent 2: Home Address

Parent 2: Home Address (2)

* Parent 2: City

* Parent 2: State

* Parent 2: Zip

List Names & Ages of Siblings

* How did you hear about the Parenting Program?

* What would you like the early childhood experience to provide for your child?

* Is there anything else that would be helpful for us to know about your child?

* Are you currently a member of Temple Shaaray Teflia?

Are you interested in learning more about temple membership?

Tue, April 23, 2024 15 Nisan 5784