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.
Email *
Child's First Name *
Child's Last Name *
Child's Birth-date *
ex. 01/01/2012
Address: *
Parent/Guardian 1 - Full Name: *
Parent/Guardian 1 - Phone: *
Parent/Guardian 1 - Email *
Parent/Guardian 2 - Full Name:
Parent/Guardian 2 - Phone:
Parent/Guardian 2 - Email
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