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 NameLast Name
Parent/Guardian 1*
Parent/Guardian 2*
First NameLast Name
Parent/Guardian 2
Maritial Status:*

Address*

Phone Number*
- Area CodePhone Number
Shul Affiliation*
Rabbi*
Phone Number
- Area CodePhone 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?
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 NameLast Name
Child 1 Birthday*
/Month /DayYear
Child 1 Grade Entering*
Child 2 Name
First NameLast Name
Child 2 Birthday
/Month /DayYear
Child 2 Grade Entering
Child 3 Name
First NameLast Name
Child 3 Birthday
/Month /DayYear
Child 3 Grade Entering
Child 4 Name
First NameLast Name
Child 4 Birthday
/Month /DayYear
Child 4 Grade Entering
Should be Empty:

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Family Information