ECC Application Form

KI Early Childhood Center Application for Admission

Student Information

* Student First Name:

Student Middle Name:

* Student Last Name:

Student Preferred Name:

Gender:

Student Birthdate:

Inquiring for Year:

Siblings Who Have Attended KI ECC:

Parent/Guardian Information

(Note: Parent A vs. Parent B does not imply a primary contact, it's just a way of delineating between parents when collecting information.)

* Parent A First Name:

* Parent A Last Name:

* Parent A Cell Phone:

* Parent A Email:

Parent B First Name:

Parent B Last Name:

Parent B Cell Phone:

Parent B Email:

Primary Home Address:

Address Line 2

City:

State:

Zip Code:

How did you hear about KI Early Childhood Center?

I would like more information about:

Payment

* ECC Application Fee: $150.00

Please Select OneECC 2022-2023 Application Fee $150.00

Sat, December 3 2022
9 Kislev 5783

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Thursday ,
DecDecember 1 , 2022

Tikkun Olam Toy Drive
Thursday, Dec 1st (All day)

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Saturday ,
DecDecember 3 , 2022

Shabbat Afternoon Service: Bar Mitzvah of William Perelman
Shabbat, Dec 3rd 4:15p to 6:00p

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Wednesday ,
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1 Topic, 2 Rabbis, 3+ Opinions
Wednesday, Dec 7th 7:00p to 8:30p

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Saturday ,
DecDecember 10 , 2022

Shabbat Morning Service: Bat Mitzvah of Carmen Carney
Shabbat, Dec 10th 10:00a to 12:00p

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Saturday ,
DecDecember 10 , 2022

Shabbat Afternoon Service: Bat Mitzvah of Ella Rich
Shabbat, Dec 10th 4:30p to 6:00p

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Sat, December 3 2022 9 Kislev 5783

ECC Application Form

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Parent/Guardian Information

Payment

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