ACI MASKIT 2018 - 2019 (5779) Registration Form
This form should be used for students enrolling in the upper school as well as new and returning students enrolling in the lower school.
Child Information
Name of Child (first and last name) *
Your answer
Hebrew name
Your answer
Age *
Your answer
Boy/Girl *
Child's email address
Your answer
Current school name and grade *
Your answer
Dismissal time from school on Tuesdays (for lower school only)
Time
:
Date of Birth *
MM
/
DD
/
YYYY
Child's interests/talents
Your answer
Special needs (if applicable)
Your answer
Child's current Jewish background/education *
Your answer
Parent Information
Father's English name (first and last) *
Your answer
Father's Hebrew name
Your answer
Mother's English name (first and last) *
Your answer
Mother's Hebrew name
Your answer
Address *
Your answer
Home Phone *
Your answer
Father's cell phone
Your answer
Mother's cell phone
Your answer
Father's email address
Your answer
Mother's email address *
Your answer
Father's work phone
Your answer
Mother's work phone *
Your answer
Emergency contact instructions (including name and ph. number) *
Your answer
Other children (names and ages)
Your answer
Is there anything specific you would like us to know about your child or family?
Your answer
I wish to enroll my child in ACI's MASKIT program:
Submit
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