Application

Clear Form
☐ 2019-20 Fall
☐ 2019-20 Winter

Toddler Program (14 months – 2 years old)
4 or 5 days
Half Day: 9 am – 12:15 pm
Full Day: 9 am – 2:45 pm

Primary Program (3 – 4 years old)
5 days
Half Day: 8:30 am – 12:15 pm
Full Day: 8:30 am – 2:45 pm

☐ Primary: Half Day
☐ Primary: Full Day
☐ Toddler: Half Day
☐ Toddler: Full Day
☐ Elementary
☐ Kindergarten
Only Toddlers may attend 4 days. All other must attend 5 days.

Child

☐ English
☐ Hebrew
☐ Spanish
☐ French
☐ Portuguese
☐ Other:
☐ M
☐ F

Mother / Guardian

(Mrs., Ms., Dr., etc.)

Father / Guardian

(Mr., Dr., etc.)

Background information

Please list every school, daycare, or program that your child has attended and the number of years they were at each one.
School NameNumber of Years
What are your educational goals for your child?
What role can we expect the child's parent(s)/guardian(s) to play in facilitating this child's educational goals?
What role can we expect the child's parent(s)/guardian(s) to play in facilitating this child's educational goals?
Does your child have any hobbies, sports, or special interests, capabilities or talents?
How do you see your child in their social and emotional development?
Please describe your child's educational experience thus far. What has been successful? What has been challenging?
Has your child had any remedial work, special tutoring, or enlightenment classes in the past two years? Please explain.
What are your child's strengths?
Are there any areas in which we may be able to give special help and encouragement to your child?
Does your child have any developmental concerns? If so, please describe.

Please provide the office with any evaluations, reports, assessments, IFSPs, or IEPs

Financial Aid Application

If you wish to apply for financial aid, please complete the information below and provide the office with your 2 most recent pay stubs or a copy of the first page of your most recent tax return. If there are any extenuating circumstances that you would like us to be aware of please provide us with a letter of explanation.

Non-Discrimination Policy

We value diversity among our students. We do not discriminate in our enrollment policies on the basis of race, color, gender, religion, sexual orientation, national or ethnic origin.