Prospective Family Information

Dear Parents,
We are honored that you are considering Cheder Menachem for your child.
Please complete the form below to request an appointment to meet.
This form is not an application and is no guarantee of admittance.
Family Information
Parent/Guardian 1*
First Name Last Name
Parent/Guardian 1*
Parent/Guardian 2*
First Name Last Name
Parent/Guardian 2
Maritial Status:*

Address*

Phone Number*

Area Code Phone Number
Shul Affiliation*
Rabbi*
Phone Number

Area Code Phone Number
How did you hear about our school?
Which school are your children currently attending?*
If your children are attending another school, what is the reason for changing schools?
If applicable, what schools are your other children attending?
Has any of the parents or the child himself converted?*
If applicable, please upload a conversion document.
Child Information
Please fill out this section for only the children for which you are interested in sending to Cheder Menachem.
Child 1 Name*
First Name Last Name
Child 1 Birthday*

Month Day Year
Child 1 Grade Entering*
Child 2 Name
First Name Last Name
Child 2 Birthday

Month Day Year
Child 2 Grade Entering
Child 3 Name
First Name Last Name
Child 3 Birthday

Month Day Year
Child 3 Grade Entering
Child 4 Name
First Name Last Name
Child 4 Birthday

Month Day Year
Child 4 Grade Entering
Should be Empty:

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Family Information