Infant Little Jems Preschool Registration
INFANT Information
INFANT
Name
*
First Name
Last Name
Gender
*
Male
Female
Hebrew Name
*
Date of Birth
*
-
Month
-
Day
Year
Date
Previous daycare or schooling experience
*
General Information
What expectations do you have for your baby at our school?
*
Please comment on an aspect your baby that you consider unique or special
*
What language does your baby speak at home?
*
Please note any health problems or allergies that your baby has
*
Program Choice
Tuition ($2,200/month)
*
Please Select
1 month ($1,490)
2 months ($2,980)
3 months ($4,470)
4 months ($5,960)
5 months ($7,450)
6 months ($8,940)
7 months ($10,430)
8 months ($11,920)
9 months ($13,410)
10 months ($14,900)
Includes lunch
Extended Care
Early Care (8am-9am) $300/month
After Care (3pm-4pm) $300/month
After Care (4pm-5pm) $300/month
Early Care (8am-9am)
*
Please Select
1 month ($300)
2 months ($600)
3 months ($900)
4 months ($1,200)
5 months ($1,500)
6 months ($1,800)
7 months ($2,100)
8 months ($2,400)
9 months ($2,700)
10 months ($3,000)
After Care (3pm-4pm)
*
Please Select
1 month ($300)
2 months ($600)
3 months ($900)
4 months ($1,200)
5 months ($1,500)
6 months ($1,800)
7 months ($2,100)
8 months ($2,400)
9 months ($2,700)
10 months ($3,000)
After Care (4pm-5pm)
*
Please Select
1 month ($300)
2 months ($600)
3 months ($900)
4 months ($1,200)
5 months ($1,500)
6 months ($1,800)
7 months ($2,100)
8 months ($2,400)
9 months ($2,700)
10 months ($3,000)
Register another child
Add Child
General Information
What expectations do you have for your child at our school?
*
Please comment on an aspect your child that you consider unique or special
*
What language does your child speak at home?
*
Please note any health problems or allergies that your child has
*
Program Choice
Tuition ($1,490/month)
*
Please Select
1 month ($1,490)
2 months ($2,980)
3 months ($4,470)
4 months ($5,960)
5 months ($7,450)
6 months ($8,940)
7 months ($10,430)
8 months ($11,920)
9 months ($13,410)
10 months ($14,900)
Includes lunch
Extended Care
Early Care (8am-9am) $300/month
After Care (3pm-4pm) $300/month
After Care (4pm-5pm) $300/month
Early Care (8am-9am)
*
Please Select
1 month ($300)
2 months ($600)
3 months ($900)
4 months ($1,200)
5 months ($1,500)
6 months ($1,800)
7 months ($2,100)
8 months ($2,400)
9 months ($2,700)
10 months ($3,000)
After Care (3pm-4pm)
*
Please Select
1 month ($300)
2 months ($600)
3 months ($900)
4 months ($1,200)
5 months ($1,500)
6 months ($1,800)
7 months ($2,100)
8 months ($2,400)
9 months ($2,700)
10 months ($3,000)
After Care (4pm-5pm)
*
Please Select
1 month ($300)
2 months ($600)
3 months ($900)
4 months ($1,200)
5 months ($1,500)
6 months ($1,800)
7 months ($2,100)
8 months ($2,400)
9 months ($2,700)
10 months ($3,000)
Parents Info
Mother
*
Father
*
Contact Info
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Family Info
Siblings
List any other siblings not registering above
General
Is the Mother of the Child Jewish?
*
Yes
No
Is the Father of the Child Jewish?
*
Yes
No
Are there any conversions in the family?
*
Yes
No
Are you affiliated with a synagogue?
*
Yes
No
Does the child live with both natural parents?
*
Yes
No
Marital status of parents
*
Additional Information
I allow my name/email address to be included in a school or class directory
*
Yes
No
I allow photos of my child to be posted on Facebook and Instagram
*
Yes
No
How did you hear about us?
*
Facebook
Friend
Instagram
Website
Other
Comments
Additional Fees
Registration Fee $600
PTA $150
Earthquake Fee $30
Payment Information
Summary
Additional Fees
Tuition
Extended Care
Total
Payment Plan
IF YOU CHOOSE TO LEAVE THE PROGRAM BEFORE TO END OF THE SCHOOL YEAR, THERE WILL BE NO REFUND AS THE TUITION IS A YEARLY ONE. YOU'LL NEED TO FINISH YOUR PAYMENT PLANS.
Payment via
Credit Card
Checks (must be submitted to secure registration)
Payment Options
1 payment
10 monthly payments
Submit
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