The Jennie Registration

This registration submits you to The Jennie's enrollment waitlist, and you will be contacted when a spot opens up for your child.

Enrollment openings are based on number of children already enrolled in each class, members or employees of our congregation, and whether or not a child has a sibling already enrolled.

* Child's First Name

* Child's Last Name

* Child's Date of Birth

* Child's Gender

Child's preferred name (if different from given)

* Desired Start Date

* Hours Desired

We are pleased to offer both full- and part- time enrollment. You can find schedules and rates at www.bethisrael-pdx.org/thejennie/

* Please list any and all special needs your child has, including medical conditions or allergies:

* Parent or Primary Caregiver 1 First Name

* Parent or Primary Caregiver 1 Last Name

* Parent or Primary Caregiver 1 Cell Phone

Parent or Primary Caregiver 1 work phone

* Parent or Primary Caregiver 1 email

* Parent or Primary Caregiver 1 Address

* Parent or Primary Caregiver 1 City

* Parent or Primary Caregiver 1 State

* Parent or Primary Caregiver 1 Address Zip Code

Parent or Primary Caregiver 2 First Name

Parent or Primary Caregiver 2 Last Name

Parent or Primary Caregiver 2 cell phone

Parent or Primary Caregiver 2 work phone

Parent or Primary Caregiver 2 email

If Parent or Primary Caregiver 2 has an address other than what's listed above, please include it below

Additional Caregivers:

* Please list the names and ages of all siblings:

* Are you a member of Congregation Beth Israel?

Please Select OneYesNoIf you are interested in membership, please reach out to us.

* Are any primary caregivers employed by a Jewish organization?

Please Select OneYesNo

How did you learn about The Jennie? If you were referred to us by someone, please tell us who.

Registration Fee

$150; non-refundable registration fee for nonmembersA payment of $150.00 is required to register for the Jennie.

This fee is nonrefundable, however the fee is waived for CBI employees and members.

Registration submits you to our enrollment waitlist, and you will be contacted when a spot opens up for your child.

For non-CBI members: you will neither be enrolled nor added to our waitlist until we receive this fee.

Enrollment openings are based on classroom numbers, CBI membership status, and whether or not a child has a sibling already enrolled.

Please email the Director if you have any further questions.

Signature

By typing my full name here I attest the information on this form is true

* Date

Sat, April 27 2024
19 Nisan 5784

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