New Student Preschool Registration

Shemesh and Yam
	3 Day (M, W, F)	5 Days
Half Day (8:30-12:30)	$12,500	$18,400
Full Day (8:30-3:00)	$14,500	$20,700
Extended Day (8:30-5:00)	$16,800	$24,000

Eretz
	5 Days
Full Day (8:30-3:00)	$21,900
Extended Day (8:30-5:00)	$24,500

Student Information

* Name of Child

* Birthday:

* Gender:

* For which class are you enrolling?

Schedule Desired

5 day

3 day

3 dayMonday, Wednesday, and Friday

Desired Start Date:

School Hours

Are you enrolling a second child??

Student 2 Information

* Name of Child

* Birthday:

* Gender:

Schedule Desired

For which class are you enrolling?

5 day

3 day

3 dayMonday, Wednesday, and Friday

School Hours

Parent / Guardian 1

* First Name:

* Last Name:

* Primary Address:

* City:

* State:

* Zip Code:

* Phone 1 (Mobile):

* Phone 2 (Home):

* Email:

Is there a second parent/guardian?

Parent / Guardian 2

Name:

Does this parent/guardian live at a different address?

Primary Address:

City:

State:

Zip Code:

Phone 1:

Phone 2:

Email:

* By submitting this form, you agree to pay the $875 non-refundable application ($75) and administrative fees ($800)

By submitting this form, you agree to pay the $875 non-refundable application ($75) and administrative fees ($800)

Total Due Today

Your application fee and Administrative fees must be paid upon submission.

Sun, October 2 2022 7 Tishrei 5783