JCC East Bay Preschool Application
A $50.00 non-refundable application fee must accompany this form. After you have submitted your application, the confirmation page will give you instructions of how to pay your application fee online or mail a check.

Please write your email below to receive a copy after you submit your application.
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Email *
What is the best phone number to reach you at? *
Child's First Name *
Child's Last Name *
Child's Birthdate *
ex. 01/01/2012
Address: *
Parent/Guardian 1 - Full Name: *
Parent/Guardian 1 - Phone: *
Parent/Guardian 1 -  Email *
Parent/Guardian 1- Occupation and Employer *
Parent/Guardian 2 (if applicable) - Full Name:
Parent/Guardian 2 (if applicable) - Phone:
Parent/Guardian 2 (if applicable) -  Email
Parent/Guardian 2 (if applicable) - Occupation and Employer *
In order to enable us to proactively celebrate the many identities in our classrooms and community, we invite you to share with us how you identify. This can include, but is not limited to, gender identity or expression, sexual orientation, racial, ethnic, national, cultural or religious identity, neurodiversity. This question is optional and your personal information will be kept confidential.
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