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ADMISSIONS APPLICATION

Fill out this form to apply.

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CELC ADMISSIONS FORM 2025-2026

We’re excited for a wonderful year with you and your child. Please fill out the form below to begin the admissions process.

Child Name*
First Last
Hebrew Name (If Known)
How Should Your Child Be Called?
Gender*
- Boy
- Girl
DOB*
MM slash DD slash YYYY
Time Of Birth
Age*
Home Phone*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Parent Information
Father's Name*
First Last
Father's Hebrew Name ( if known)
First
Father's Cell*
Father's Email*

Please note that CELC uses email as its primary means of communication. Please provide us with the email address you use most frequently
Occupation*
Business Name
Business Phone
Mother's Name*
First Last
Mother's Hebrew Name ( if known)
First
Mother's Cell*
Mother's Email*

Please note that CELC uses email as its primary means of communication. Please provide us with the email address you use most frequently
Occupation*
Business Name
Business Phone
Marital Status (choose one option)*
- Married
- Separated
- Widowed
- Divorced
Persons to be contacted in case of an emergency when parents cannot be reached. Please provide at two contacts.
Name 1*
First Last
Phone*
Relationship to child*
Name 2*
First Last
Phone*
Relationship to child*
Does your child have any allergies or other medical condition, require medication, or any special abilities or disabilities we should be aware of?*
- Yes
- No
Please describe them and indicate special precautions or care needed.
Small Wonders ( 6 weeks- 18 Months)
- Full Day 6:30 AM - 7:00 PM
- Half Day 9:00 AM - 3:00 PM
Torah Tots (18 Months - 3 Years Old)
- EZPASS ( includes before and after care hours)
- Full Day 9:00 AM - 3:00 PM
- Half Day 9:00 AM - 12:30 PM
Primary (3 Years Old - 5 Years Old)
- EZPASS ( includes before and after care hours)
- Full Day 9:00 AM - 3:00 PM
- Half Day 9:00 AM - 1:00 PM
Which days of the week would you like to register your child?
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Before/After Care? ( Any hours before 9 am and after 3 pm )*
- Yes
- No
If you are registering for EZPass of any Before/After Care hours, please indicate all days and hours of childcare needed.
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Monday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Tuesday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Wednesday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Thursday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
Friday Drop Off Time and Pick Up Time*

Please let us know when you are dropping off, and when you are picking up.
We look forward to a wonderful year of learning and growth!

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