Parent Handbook If you did not yet read the parent handbook, please review it entirely before completing this form. I've read the following sections in the parent handbook* First Days Info / Transition ProcessSupplies needed in school and dailySchool CalendarTuition and Parent Involvement (including hours and fruit/veggies one week a month)Gan menu and daily scheduleHealth & Wellness policies Student's Information Full Name* First Name Last Name Age at start of School Year Hebrew Name* Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Previous daycare / schooling experience* Does your child have any allergies?* Choose a Program* Twice a weekThree times a weekEvery day (5x a week) Family Orientation Father* First Name Last Name Father's Occupation Was father born to a Jewish mother?* Yes No This does not affect acceptance in our program. Father's Email Father's Cell Area Code Phone Number Mother* First Name Last Name Mother's occupation Was mother born to a Jewish mother?* Yes No This does not affect acceptance in our program. Mother's Email Mother's Cell Area Code Phone Number Marital Status Please select Married Divorced Separated Single Parent Languages spoken at home Parent Involvement What area would dad be interested in participating in the Gan?* Ideas can include but are not limited to: Being a second teacher on occassion, doing a specialty with the students (art, music etc), running errands, creating/maintainig a garden, researching/planning activities (with Chyena), and more. Teaching the children a skill. The sky's the limit! What area would mom be interested in participating in the Gan?* Ideas can include but are not limited to: Being a second teacher on occassion, doing a specialty with the students (art, music etc), running errands, creating/maintainig a garden, researching/planning activities (with Chyena), and more. Teaching the children a skill. Organizing/Paying for a field trip. The sky's the limit! Do you feel that you are able to do the amount of hours each month (2-4 hours a month, depending on many days at Gan your child is at?)* Required. Please check off* In the event that 2 months go by without any involvement from either parent (after being asked), I agree to be charged $50 for every hour unfulfilled to cover resulting expenses. Credit card to have on file. Nothing will be charged today or without communication. This will not be used to cover monthly payments unless you ask us to. This is just so we can have on file (related to above question).* Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 Expiration Year Billing Address Street Address City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Emergency Information Doctor* First Name Last Name Phone Number* Area Code Phone Number Emergency Contact (if parent is not reachable)* First Name Last Name Relation to child Phone Number* Area Code Phone Number Getting to know your child What are your child's favorite activities? What do you perceive to be your child's strengths? What are your child's favorite foods and snacks? Is there any day's lunch on the menu that you foresee being a problem for your child? Which words do you use when complimenting your child? Please share with us how you discipline your child and/or gain cooperation at home? Do you have any concerns regarding your child that you would like us to be aware of? What are you hoping your child will gain and learn at Gan this year? If you could create a perfect school setting for your child, how would you describe it? Anything else you'd like to share? Thank you for taking the time to fill this out! Submit Should be Empty: This page uses TLS encryption to keep your data secure.