Gan MidPen Jewish Preschool Admission Form
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Email *
Child full name (First, Middle, Last) *
Child Hebrew name
Child birth date
Place of birth
Lives with (select option)
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Please comment on an aspect of your child that you consider unique or special
Does your child have any allergies? *
If "Yes", which allergies?
List all medical conditions, learning disabilities and special circumstances to be considered
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