CKids Application Form
Please fill out ALL fields of this form.
Child's Name
*
First Name
Last Name
Hebrew Name
Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Boy
Girl
Grade Entering
Please Select
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth
Ninth
Tenth
Does your child have any allergies?
*
Yes
No
Allergies
Jewish Education?
*
Yes
No
Add child?
Please Select
Yes
No
Child's Name
*
First Name
Last Name
Hebrew Name
Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Boy
Girl
Grade Entering
Please Select
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Does your child have any allergies?
Yes
No
Allergies
Jewish Education?
*
Yes
No
Add child?
Please Select
Yes
No
Child's Name
*
First Name
Last Name
Hebrew Name
Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Boy
Girl
Grade Entering
Please Select
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Does your child have any allergies?
Yes
No
Allergies
Jewish Education?
*
Yes
No
Family Background
Was father born Jewish?
*
Yes
No
Was mother born Jewish?
*
Yes
No
Did the child, their biological mother, or biological maternal grandmother undergo any conversion process or adoption?
*
Yes
No
Father's Name
*
First Name
Last Name
Father's email
example@example.com
Father's cellphone
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Name
*
First Name
Last Name
Mother's Email
example@example.com
Mother's Cellphone
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Picture Permission
I give permission for my child’s picture to be used for display and public relations purposes.
*
Yes
No
Payment Options
*
Pay in full
Pay in ten monthly installments
Scholarships are available upon request.
Apply for scholarship
yes
no
Statement of need
*
Please note that scholarships are subject to availability. We will contact you to let you know if your scholarship request was approved.
Submit
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