Jewish Beginnings Application Child's Information Name * First Name Last Name Hebrew Name Date of Birth * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Languages spoken at home Siblings List all names, ages and birthdays Parent 1 Name * First Name Last Name Email * Phone * (###) ### #### Occupation What is your marital status? Single (never married) Married or in a Domestic Partnership Widowed Divorced Separated Parent 2 Name First Name Last Name Email Phone (###) ### #### Occupation What is your marital status? Single (never married) Married or in a Domestic Partnership Widowed Divorced Separated Please list grandparents names and addresses below Please select the class you are looking to enroll your child in The Infant Class (6 months-16 months) The Two's Class (16 months-36 months) The Three's Class If you are applying for the INFANT CLASS please select which hours/days you are looking to send your child JB Full Day: Monday-Friday (7:30am - 5:00 pm) JB Day: Monday-Friday (8:30am -3:30pm) JB Half Day: Monday-Friday (8:30am - 1:00pm) JB Half Day: Monday, Wednesday, Friday (8:30am - 1:00pm) JB AM care (7:30am - 8:30am) If you are applying for the TWO'S CLASS, please select which hours/days you are looking to send your child JB Full Day: Monday-Friday (7:30am - 5:00pm) JB Day: Monday-Friday (8:30am - 3:30pm) JB Half Day: Monday-Friday (8:30 - 1:00pm) JB Half Day: Monday, Wednesday, Friday (8:30am -1:00pm) JB AM care (7:30am - 8:30am) If you are applying for the THREE'S CLASS, please select which hours you are looking to send your child JB Full Day: Monday-Friday (7:30am - 5:00pm} JB Day: Monday-Friday (8:30am - 3:30pm) JB Half Day: Monday-Friday (8:30am - 1:00pm) JB AM care (7:30am - 8:30am) Additional information about your child Does your child have any allergies? If yes, please explain Does your child have any medical restrictions relating to foods, activities, etc. that we should be aware of? If yes, please explain Please describe your child, your values and beliefs towards parenting and any information you would like us to know about your child or your family. That way, we can work in concert towards achieving the ultimate goal: Providing a meaningful early childhood experience for your child! Does your child receive support in... (check all that apply) Dressing or undressing Washing Toileting Eating Going to sleep Other How does your child react to new experiences, like a new teacher? Does your child have any needs in new situations that would be helpful to know? Are there any other special considerations that you would like your child's teacher to know about? If yes, please explain How would you like to get involved with sharing a special talent, volunteering in the classroom or participating in our fundraising program (e.g. Winter gift sale, Music and Movement, Yoga, Social Events etc.)? Are you in the process of teaching your child how to use the potty or toilet? What are your beliefs? Does your child need to be reminded to go to the bathroom? Yes No What age was your child toilet trained? What terms are used in your household in reference to toileting? Thank you for your application! In order to ensure your child’s spot please submit a non-refundable deposit in the amount of $400, which will be applied towards the last month of your child’s agreement. Your application is not complete until the $400 non refundable deposit has been paid.You will be redirected to the payment page once you click apply.
