Please complete this form to be included in our UPK mailing list. UPK is a full day (5 hr), 5 days a week program funded by New York State, which will ensure that the children receive the highest level of education. There is no charge for the parent, unless they opt in for Judaic program, before care, and/or after care. Space is extremely limited and we encourage you to take a moment to complete this form to be added to the mailing list. This list does not commit you or us to anything, but being part of this mailing list will ensure that you are notified when registration opens. Parents of children under the age of 4 can also submit their child's info for a future year as this is a 5 year contract with New York State.

 

Mother's First Name:
Mother's Last Name:
Mother's Cell:
Father's First Name: 
Father's Last Name:
Father's Cell:
Preferred/Main Email:
Street Address:
City:
State:
Home Phone:
Name of Child 1:
Gender:

DOB:
Name of Child 2:
Gender:
DOB
I am interested in Judaic Enrichment program (from 9-10:15am): Yes No
I will need extended care for my child(ren) (as early as 7am, up to 6 pm): Yes - Please specify hours: No
Comments: