Temple Beth Shalom Religious School Forms

Temple Beth Shalom Teen Life Forms

Religious School Registration

Please complete the form below

Student Name/ Nickname *
Student Name/ Nickname
Male
Birthdate
Birthdate
Parent #1 Preferred Phone *
Parent #1 Preferred Phone
Parent #1 Home Phone
Parent #1 Home Phone
Parent #1 Work Phone
Parent #1 Work Phone
Parent #1 Cell Phone
Parent #1 Cell Phone
Parent #2 Home Phone
Parent #2 Home Phone
Parent #2 Work Phone
Parent #2 Work Phone
Parent #2 Cell Phone
Parent #2 Cell Phone
Status of Parent
Check one
Additional Parent/Guardian Name
Additional Parent/Guardian Name
(if applicable)
Guardian Phone
Guardian Phone
(if different from student's)
Does your child have an I.E.P. ?