SCHOOL ENROLLMENT FORM 2019-2020
This form is to register a new child for the Temple Am Echad Religious School.
Parent 1 Information
Parent 1 First Name *
Parent 1 Last Name *
Parent 1 Hebrew Name
Parent 1 Address *
Parent 1 City *
Parent 1 Zip Code *
Parent 1 E-mail Address *
Parent 1 Home Phone *
Please enter using the following format: xxx-xxx-xxxx
Parent 1 Cell Phone *
Please enter using the following format: xxx-xxx-xxxx
Parent 2 Information
Parent 2 First Name *
Parent 2 Last Name *
Parent 2 Hebrew Name
Parent 2 E-mail Address *
Parent 2 Cell Phone *
Please enter using the following format: xxx-xxx-xxxx
Does the student reside full time with both parents above? *
Emergency Contact Information
Emergency Contact 1 Name *
Emergency Contact 1 Relationship to Student *
Emergency Contact 1 Phone *
Please enter using the following format: xxx-xxx-xxxx
Emergency Contact 2 Name *
Emergency Contact 2 Relationship to Student *
Emergency Contact 2 Phone *
Please enter using the following format: xxx-xxx-xxxx
Next
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