Gan Avraham Preschool Application

336 Euclid Avenue, Oakland, California 94610
You MUST Submit before leaving this form or ALL entries will be lost.

Child

Enter the child's full name (example: use Joseph not Joe)
Gender *
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Program request

Days per week: How many days per week are you requesting to enroll your child?
Arrive and depart: What times do you plan for your child to arrive and depart Gan Avraham
Requests are not guaranteed
Days per week *
Arrive *
Depart *

Parent or legal guardian

Enter telephone numbers as 10 digits with no other characters
Temple Beth Abraham *
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Second parent or legal guardian

All appropriate fields in this section must be completed in full if your child has a surviving second parent or legal guardian. Check below if your child does not have a surviving second parent or legal guardian.
No second parent
Second parent address
Enter telephone numbers as 10 digits with no other characters

About your child

Previous child care: Include family care, preschools, etc.
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Enter the names of siblings and their birth dates.
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Gan Avraham
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Gan Avraham
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Gan Avraham

Parent or legal guardian signature

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