ECC Application Form

KI Early Childhood Center Application

Student Information

Student First Name:

Student Middle Name:

Student Last Name:

Student Preferred Name:

Gender:

Student Birthdate:

Birth Country:

Inquiring for Year:

Siblings Who Have Attended KI ECC:

Age:

Parent/Guardian Information

Primary contact First Name:

Primary contact Last Name:

Primary contact Relation:

Primary contact Cell Phone:

Primary contact Email:

Secondary contact First Name:

Secondary contact Last Name:

Secondary contact Relation:

Secondary contact Cell Phone:

Secondary contact 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 2019-2020 Application Fee $150.00ECC 2020-2021 Application Fee $150.00ECC 2021-2022 Application Fee $150.00ECC 2022-2023 Application Fee $150.00

Sat, September 26 2020
8 Tishrei 5781

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Friday ,
SepSeptember 4 , 2020

HHD Food Drive for the Westside Food Bank
Friday, Sep 4th (All day)

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Sunday ,
SepSeptember 27 , 2020

Kol Nidre (Schools and Office Closed at 1pm)
Sunday, Sep 27th (All day)

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Sunday ,
SepSeptember 27 , 2020

One on One Outreach
Sunday, Sep 27th 4:30p to 5:30p

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Monday ,
SepSeptember 28 , 2020

Yom Kippur (Schools and Offices Closed)
Monday, Sep 28th (All day)

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Monday ,
SepSeptember 28 , 2020

Yizkor
Monday, Sep 28th 5:30p to 6:00p

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Sat, September 26 2020 8 Tishrei 5781

ECC Application Form

Student Information

Parent/Guardian Information

Payment

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