| First Name (*) |
Please let us know your name. |
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| Last Name (*) |
Please let us know your name. |
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| What name does your child like to be called by? |
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| Gender |
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| Birthdate (*) |
Please use the format of month/day/year |
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If your child is not currently enrolled at CBI Preschool & Kindergarten, please fill in the following information. |
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| Please Describe Your Child. |
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| Has your child been enrolled in another early childhood program? |
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| If yes, which one? |
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| Why do you think CBI Preschool & Kindergarten is the right fit for your child and family? |
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| Parent/Guardian First Name (*) |
Please let us know your name. |
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| Parent/Guardian Last Name (*) |
Please let us know your name. |
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| Preferred Contact Method |
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| Email Address |
Please provide a valid email address. |
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| Primary Contact Phone Number |
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| Secondary Phone Number |
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| Street Address |
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| City |
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| Zip Code (*) |
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| Parent/Guardian 2 First Name (*) |
Please let us know your name. |
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| Parent/Guardian 2 Last Name (*) |
Please let us know your name. |
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| Preferred Contact Methon |
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| Email Address |
Please provide a valid email address. |
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| Primary Contact Phone Number |
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| Secondary Phone Number |
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If your address is the same as above, please leave these address fields blank. |
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| Street Address |
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| City |
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| Zip Code (*) |
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Schedule Information |
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| Are you registering your child for Kindergarten? (Mon-Fri 8:30-3:00) If yes, skip to question about early dropoff. |
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Please tell us about your ideal schedule. |
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| Monday |
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| Tuesday |
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| Wednesday |
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| Thursday |
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| Friday |
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| Would you like to do early dropoff? (8:00-9:00) |
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| Would you like to do late pickup? (3:30-5:30) |
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| Is your schedule flexible? |
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| Please explain your flexibility. |
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Please note that we do our best to accomodate all requests for schedules. A request for a schedule is not a guarantee that we will be able to offer this schedule. |
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| Are you a member of Congregation Beth Israel? |
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| Would you like to know more about our financial aid possibilities? |
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| Is there any other information you would like to share with us? |
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