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Early Childhood

Enrollment Information Request Form

Thank you for your Bureau of Jewish Education Early Childhood Enrollment Information Request.


COMPLETION OF THIS FORM SENDS YOUR CHILD'S INFORMATION TO THE BUREAU OF JEWISH EDUCATION FOR THE PROGRAM IN YEAR INDICATED. YOU WILL BE CONTACTED BY THE DIRECTOR IN THE NEAR FUTURE. WE HAVE A NON-DISCRIMINATORY ADMISSIONS POLICY AND ADMITS STUDENTS OF ANY RACE, COLOR, NATIONALITY, RELIGIOUS AND ETHNIC ORIGIN.

For specific questions, please contact Elaine Fairfield at 255-3124, ext. 3704.

* required information

*School Year Requested: - 20
*Program:
Age 2 (3 day) Age 2 (2 day) Age 3 (3 day)
Age 3 (5 day) Age 4  
Jr. Kindergarten Kindergarten  
*Full name of child:
Nickname:
*Child Date of Birth:
*Address:
*City:
*Zip Code:
Email:
*Home Phone:
Work Phone:
Cell Phone:
*Mother's Name:
*Father's Name:
Referred By:
Synagogue:
Is your child tiolet trained? Yes   No
 
Date Received:

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Bureau of Jewish Education, Inc. | Smulyan-Stolkin Education Center

6711 Hoover Road | Indianapolis, Indiana 46260 | Phone: 317.255.3124 | Fax: 317.254.0265

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