Child's Name
Parent's Name
Child's Birthdate
Age of Child at Date of Application
Phone Numbers: Home/Work/Cell
Address
Email
Religious Affiliation
Desired Enrollment Date
Desired Location
Gordon JCC
West End Synagogue
Please check the days preferred for 8:30 a.m. to 3:00 p.m. program:
5 day program Monday - Friday (Infants and PreK must attend 5 day program)
3 day program Mon/Wed/Fri
2 day program Tues/Thurs
Extended Care: Please check the categories if needed:
Morning Care 7:30 a.m.-8:30 a.m. 2 day
Morning Care 7:30 a.m.-8:30 a.m. 3 day
Morning Care 7:30 a.m.-8:30 a.m. 5 day
After Care 3:00 p.m.-4:30 p.m. 2 day
After Care 3:00 p.m.-4:30 p.m. 3 day
After Care 3:00 p.m.-4:30 p.m. 5 day
After Care 3:00 p.m.-6:00 p.m. 2 day
After Care 3:00 p.m.-6:00 p.m. 3 day
After Care 3:00 p.m.-6:00 p.m. 5 day
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