SFJA New Student Information

SFJA New Student Application

Student Information
Child's Legal Name

First NameLast Name
Child's Hebrew Name
Child's Known Name if Different to Legal Name
Child's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's D.O.B.

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate of birth
Does your child have any siblings?
How many children?
Sibling #1 is write a age* years old and attends name of school* for school
Sibling #2 is write a age* years old and attends name of school* for school
Sibling #3 is write a age* years old and attends name of school* for school
Sibling #4 is write a age* years old and attends name of school* for school
Sibling #5 is write a age* years old and attends name of school* for school
Sibling #6 is write a age* years old and attends name of school* for school
Current Grade Attending
Child's Cell Phone Number

Area CodePhone Number
Home Phone Number

Area CodePhone Number
Child's Email
example@example.com
Upload Picture of your child
Current School
School Phone Number

Area CodePhone Number
Grade Entering
Math Grade Level
Current grade level
Reading Grade Level
Current grade level
Judaic Grade Level
Current grade level
Past Expulsions / Suspensions
If yes, Please list:
What is your goal for your child(ren)?
Health Information
Does your child have a IEP or any other test results
Upload all test results, recommendations, including IEPs.
Does your child require any additional services

Other
If yes, Please list:
Does your child have any official diagnoses?
If yes, Please list:
Does your child have learning differences or challenges?
If yes, Please list:
Does your child have any allergies?
If yes, what is your child allergic to?
Does your child carry an EpiPen and/or Inhaler?
Toilet Trained
Parents Information
Parent's Marital Status
Student lives with
Scholarships
Mother's Name

First NameLast Name
Mother's Hebrew Name
Mother's Cell Phone Number

Area CodePhone Number
Mother's Email
example@example.com
Father's Name

First NameLast Name
Father's Hebrew Name
Father's Cell Phone Number

Area CodePhone Number
Father's Email
example@example.com
Congregation with which family is affiliated Name of Rabbi / Shul
Is either the mother or father not born of Jewish faith
Which parent was not born Jewish
Is the conversion completed yet?
Name of Rabbi who did conversion
Rabbi Phone Number

Area CodePhone Number
How did you hear about us?
Tour Appointment Request
Terms and Conditions
Mothers Signature
Fathers Signature

My Products

New Student application fee$100.00

Enter coupon

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

SFJA New Student Application

Health Information

Parents Information

My Products*

My Products