Bill and Sid Rubin Preschool Inquiry - Form

Thank you for your interest in the Bill and Sid Rubin Infant Toddler Center and Preschool @ Beth Israel. Please fill out the following information so that we may assist you and understand what your family is looking for in infant/toddler care or preschool.

Space is limited for ages 2-5 for the 2023-2024 Preschool Year.
Our Infant Toddler Center is currently FULL. We have very limited space available for infants and toddlers beginning in Spring or Summer 2024.

A member of our school office team will be in touch soon!

* Parent 1 Full Name

* Parent 1 Cell Phone

* Parent 1 Email

Parent 2 Full Name

Parent 2 Cell Phone

Parent 2 Email

Home Address

City

State

Zip Code

* Child 1 Full Name

* Child 1 Gender

UnknownFemaleMale

* Child 1 Birthdate or anticipated due date

Which program are you interested in learning more about for child 1?

Infant Toddler Center: 3+ MonthsPreschool 2023-2024: 2 year olds - Pre K

Does your child have any previous school experience?

YesNo

If yes, please explain:

Child 2 Full Name

Child 2 Gender

UnknownFemaleMale

Child 2 Birthdate or anticipated due date

Which program are you interested in learning more about for child 2?

Infant Toddler Center: 3+ MonthsPreschool: 2 year olds - Pre K

Does child 2 have any previous school experience?

YesNo

If yes, please explain:

How did you hear about us?

How many days per week are you interested in?

235Flexible

How many hours of care are you seeking?

Part Time (9am-1pm)Morning Care (7:30am-9am)Extended Care (1pm-4pm)Extended Care (1-5pm)

* When do you hope/plan to begin your child(ren)'s enrollment?

Are both parents Jewish?

Is one parent Jewish?

Are you already a Beth Israel Member?

If not, is your family interested in learning more about Temple Membership?

Comments/Any additional information you would like to share with us: