Bill and Sid Rubin Preschool Inquiry - Form

Thank you for your interest in Congregation Beth Israel's Bill and Sid Rubin Infant Toddler Center and Preschool. Our infant toddler center cares for children from 3-24 months of age. Our preschool cares for children from 2-5 years of age. 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.

We currently have spaces available for in our infant and toddler classes (ages 3-24 months), as well as our preschool classes (2-5 years).
We offer rolling admissions year around for all of our classes.

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 2025-2026: 2 year olds - Pre KSummer Camp 2026: 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 2025-2026: 2 year olds - Pre KSummer Camp 2026: 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?

2345

How many hours of care are you seeking?

Part Time (9 am - 1 pm)Full Time (7:30 am - 5 pm)

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

Are one or both parents Jewish?

Are you already a member of Beth Israel?

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

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