New Student Application 2017 2018 School Year
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- If applying for the Extended Day Program (7:30 a.m. - 6:00 p.m.) please also choose one
- Please contact the following people in case of emergency if my child’s parents / guardians are unreachable
- The following people are authorized to pick up my child from the Weinberg Early Learning Center
- Important Admission Information Application Fee: There is a $100.00 Non-refundable
- Signature of Parent/Guardian _______________________________________________ Date: ________________ Please enclose a $100.00 Non-refundable, Non-transferable application fee
- Additional Offerings Early Morning Care
New Student Application 2017 - 2018 School Year
Class Options – Please Choose One: Toddler Program _____ (2-Days) _____ (3-Days) ______ (5-Days) (18 Months - 23 Months) _____ (2-Days January) 2 Year Old program _____ (3-Days) _____ (5-Days) 3 Year Old program _____ (4-Days) _____ (5-Days) 4 Year Old program _____ (5-Days) If applying for the Extended Day Program (7:30 a.m. - 6:00 p.m.) please also choose one: _____ (2-Days) _____ (3-Days) _____ (4-Days) _____ (5-Days) Temple Members: Yes/No Student’s Age on September 1, 2017: _________ [ ] Male [ ] Female Student’s Full Name: __________________________________________________ Date of Birth: ____/____/________ Student Prefers to be Called: _________________________________ Home Phone: ___________________________ Student’s Home Address: ____________________________________________________________________________ ___________________________________________________________________________ If you would like WELC communications sent to a mailing address other than the student’s, please list the address below: ______________________________________________________________________________________________ (Street) (City) (State) (Zip Code) S tudent’s Living Arrangements: Both Parents Mother Father Other ______________________ S tudent’s Legal Guardian(s): Both Parents Mother Father Other _____________________________ Parent/Guardian: _____________________________ Parent/Guardian: _______________________________ Jewish _______ Yes _______No Jewish ______ Yes ______ No Occupation: __________________________________ Occupation: ____________________________________ Place of Employment: __________________________ Place of Employment: ____________________________ Work Phone: (____) ____________________________ Work Phone: (____) _____________________________ Cell Phone: (____) ____________________________ Cell Phone: (____) _____________________________ Home Address: _______________________________ Home Address: _________________________________ (if different from child’s) (if different from child’s) Home Phone: (____) ___________________________ Home Phone: (____) _____________________________ (if different from child’s) (if different from child’s) Email: ______________________________________ Email: ________________________________________ Siblings who reside with the student: Name: _________________________ DOB: ________ Current School: _____________________________ Name: _________________________ DOB: ________ Current School: ______________________________ Siblings who do not reside with the student: Name: _________________________ DOB: ________ Current School: _____________________________ Name: _________________________ DOB: ________ Current School: _____________________________ Please contact the following people in case of emergency if my child’s parents / guardians are unreachable: Name: ___________________________________________ Relationship to child: ______________________________ Home Phone: _____________________ Cell Phone: _______________________ Work Phone: ___________________ Name: ___________________________________________ Relationship to child: ______________________________ Home Phone: ____________________ Cell Phone: _______________________ Work Phone: ___________________ The following people are authorized to pick up my child from the Weinberg Early Learning Center: Name: ___________________________________________ Relationship to child: ______________________________ Home Phone: _____________________ Cell Phone: _______________________ Work Phone: ___________________ Name ___________________________________________ Relationship to child_______________________________ Home Phone: ____________________ Cell Phone: _______________________ Work Phone: ___________________ Please list any current or previous medical or psychological issues regarding your child of which we should be aware: _ ____________________________________________________________________________________ or None P
lease list any regular medication that your child takes __________________________________________ or None NOTE: Parent/Guardian must complete a Medication Form authorizing the WELC to dispense any medication. P lease describe any challenges, learning differences or special needs that might affect your child’s experience at the WELC___________________________________________________________________________________________ _____________________________________________________________________________________ or None
y child currently/previously received Physical Therapy Occupational Therapy Speech Therapy None (please check all that apply) If checked, please describe __________________________________________________________________________ Please list any food restrictions or food allergies your child has ______________________________________________ _
____________________________________________________________________________________ or None Please share anything else you feel we should know about your child _________________________________________ ______________________________________________________________________________________ or None Important Admission Information Application Fee: There is a $100.00 Non-refundable, Non-transferable application fee for each new student application.
Additional details regarding the Weinberg Early Learning Center‘s Admission Policy may be found on our website. My signature verifies that the information on this application is accurate and true. I understand that if my child is admitted to the WELC, the first tuition payment is due within 10 days of acceptance to secure a class placement. Signature of Parent/Guardian _______________________________________________ Date: ________________ Please enclose a $100.00 Non-refundable, Non-transferable application fee made payable to the WELC for each New Student application. Additional Fees The annual Snack Fee and TPA Dues (The Parent Association) will be listed on the Enrollment Contract that you will receive upon your child’s acceptance into the WELC. Class Hours Children in the Toddler classes will attend school from 9:30 a.m. – 12:30 p.m. and will eat lunch at school. Children in all other classes will attend school from 9:30 a.m. – 1:30 p.m. and will eat lunch at school. Children enrolled in the Extended Day Program may attend from 7:30 a.m. – 6:00 p.m. in either the 2-day, 3-day, 4-day or 5-day programs. Additional Offerings Early Morning Care is available for children enrolled in any program from 8:30 a.m. – 9:30 a.m. Monday through Friday for an additional fee. Registration is offered for the semester or entire school year. This program may be used on an as-needed, drop-in basis if space permits. More Toddler Time is available for children enrolled in the toddler program from 12:30 p.m. – 1:30 p.m. Monday through Friday for an additional fee. Registration is offered for the semester or entire school year. This program may be used on an as-needed, drop-in basis if space permits. Stay & Play is available for children enrolled in the 2, 3 and 4 year old programs from 1:30 p.m. to 3:00 p.m. Monday through Friday for an additional fee. Registration is offered for the semester or entire school year. This program may be used on an as-needed, drop-in basis if space permits. Enrichment Classes are available for each day of the week from 1:30 p.m. – 3:00 p.m. Monday through Friday for an additional fee. The schedule of classes is available in late August. 
TELC Admission Policy is posted on our website. WELC Office Use Only Date Received: _________________ Chavareware: _________________ Application Fee Paid: ________________ Decision Letter Sent: __________________ Weinberg Early Learning Center at The Temple 1589 Peachtree Street, NE | Atlanta, GA 30309 | (404) 872-8668 Directory: Portals Portals -> Draft I film Screening Portals -> Black History Academic Bowl arts & entertainment Portals -> Setting the Table for a Successful Season Download 34.31 Kb. Share with your friends:
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