Waitlist - Taubman Early Childhood Center Registration - Form

Waitlist - Taubman Early Childhood Center Registration

WAITLIST
2023-2024 Taubman Early Childood Center

Everyone must provide proof of state mandated immunization for admission.
We do not accept religious exemption.

Today's Date:

* Parent/Guardian 1 - First Name

* Parent/Guardian 1 - Last Name

* Parent/Guardian 1 - Mobile Phone

* Parent/Guardian 1 - Email Address

* Student's Address

* Student's City

* Student's State

* Student's Zip Code

* Is there a second parent/guardian?

* Parent/Guardian 2 - First Name

* Parent/Guardian 2 - Last Name

* Parent/Guardian 2 - Mobile Phone

* Parent/Guardian 2 - Email Address

Does Parent/Guardian 2 live at the same address?

Parent/Guardian 2 - Address

Parent/Guardian 2 - City

Parent/Guardian 2 - State

Parent/Guardian 2 - Zip Code

* Are you a Member of B'nai Torah?

Please Select OneYesNo

* Do you currently have children enrolled in our ECC or Family Time program?

Please Select OneYesNo

* How many children will you be adding to a our waitlist?

*$100 Non-Refundable Waitlist Fee per student

You will be placed on our Waitlist for the upcoming school year at the Taubman Early Childhood Center. This fee will be applied to your Registration Fee upon admittance to our program. When offered a placement (by phone and via email), you will have 48 hours to respond before we move to the next name on our list.

*If a spot is offered to you and you do not respond or refuse enrollment, your name will be removed from our list.

While we make no guarantee, in the event that a placement does not become available during the 2023-2024 school year, you will have a priority enrollment status for the following school year as a currently wait listed family.

Child 1 - First Name

Child 1 - Last Name

Child 1 - Date of Birth

Child 1 - Gender

* Choose Child #1's group:

* Child #1's Schedule:

Child 2 - First Name

Child 2 - Last Name

Child 2 - Date of Birth

Child 2 - Gender

* Choose Child #2's group:

* Child #2's Schedule:

Child 3 - First Name

Child 3 - Last Name

Child 3 - Date of Birth

Child 3 - Gender

* Choose Child #3's group:

* Child #3's Schedule:

Mon, June 5 2023 16 Sivan 5783